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To freeze or not to freeze: a cost-effectiveness analysis of wart treatment

M R Keogh-Brown, R J Fordham, K S Thomas, M O Bachmann, R C Holland, A J Avery, S J Armstrong, J R Chalmers, A Howe, S Rodgers, H C Williams, I Harvey
British Journal of Dermatology 2007, 156 (4): 687-92

BACKGROUND: Several general practitioner (GP)-prescribed and over-the-counter therapies for warts and verrucae are available. However, the cost-effectiveness of these treatments is unknown.

OBJECTIVES: To compare the cost-effectiveness of different treatments for cutaneous warts.

METHODS: We designed a decision-analytic Markov simulation model based on systematic review evidence to estimate the cost-effectiveness of various treatments. The outcome measures studied are percentage of patients cured, cost of treatment and incremental cost-effectiveness ratio for each treatment, compared with no treatment, after 18 weeks.

RESULTS: Duct tape was most cost-effective but published evidence of its effectiveness is sparse. Salicylic acid was the most cost-effective over-the-counter treatment commonly used. Cryotherapy administered by a GP was less cost-effective than GP-prescribed salicylic acid and less cost-effective than cryotherapy administered by a nurse.

CONCLUSIONS: Duct tape could be adopted as the primary treatment for cutaneous warts if its effectiveness is verified by further rigorous trials. Nurse-administered cryotherapy is likely to be more cost-effective than GP-administered cryotherapy.

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