Real-life Data on Patient Characteristics, Cost and Effectiveness of Field-directed Treatment for Actinic Keratoses: An Observational Study.
Actinic keratoses (AK) occur frequently; however, real-life clinical data on personalized treatment choice and costs are scarce. This multicentre one-year observational study investigated patient-characteristics, cost and effectiveness of methylaminolaevulinate photodynamic therapy (MAL-PDT), imiquimod (IMI) and 5-fluorour-acil (5-FU) in patients with AKs on the face/scalp. A total of 104 patients preferred MAL-PDT, 106 preferred IMI and 110 preferred 5-FU. At baseline, significant differences between treatment groups were found; most patients were severely affected (mean 32.5 AK in PDT-group, 20.2 in IMI-group, 22.8 in 5-FU-group). A mean reduction in lesions of 81% after MAL-PDT, 82% after IMI and 88% after 5-FU was found after one year. Annual costs were €1,950 for MAL-PDT, €877 for IMI and €738 for 5-FU. These results show that, compared with clinical trials, in the real-life clinical setting AK patients are usually more severely affected and treatment costs are much higher. Furthermore, patient characteristics are important factors in treatment choice.
Department of Dermatology, Radboud University Medical Centre, 6500 HB Nijmegen, The Netherlands. Margit.vanRijsingen@radboudumc.nl.
Margit C J
MC
van Rijsingen
Inge
I
Seubring
Janneke P C
JP
Grutters
M Birgitte
MB
Maessen-Visch
Hans A C
HA
Alkemade
Remco
R
van Doorn
Hans
H
Groenewoud
Peter C M
PC
van de Kerkhof
Gert Jan
GJ
van der Wilt
Marie-Jeanne P
MJ
Gerritsen
D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D000634:Aminoquinolines / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D003879:Dermatologic Agents / Q000191:economics* / Q000627:therapeutic use*; D016527:Drug Costs; D005260:Female; D005472:Fluorouracil / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D000077271:Imiquimod; D055623:Keratosis, Actinic / Q000188:drug therapy* / Q000191:economics*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D057240:Patient Preference; D010778:Photochemotherapy / Q000191:economics* / Q000379:methods; D017319:Photosensitizing Agents / Q000191:economics* / Q000627:therapeutic use*; D012074:Remission Induction; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D000634:Aminoquinolines; D003879:Dermatologic Agents; D017319:Photosensitizing Agents; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid; D000077271:Imiquimod; D005472:Fluorouracil