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A study into the cost effectiveness of four treatments for actinic keratosis in the head and neck area
Publication year - 2020
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.19439
Subject(s) - actinic keratosis , imiquimod , field cancerization , dermatology , medicine , head and neck , skin cancer , keratosis , basal cell , photodynamic therapy , fluorouracil , head and neck cancer , cancer , surgery , chemistry , organic chemistry
An actinic keratosis (AK) is an area (lesion) of sun‐damaged skin, mainly found on sun‐exposed parts of the body. Left untreated, there is a small risk that an AK could progress into a type of keratinocyte carcinoma (also called non‐melanoma skin cancer) called cutaneous squamous cell carcinoma. Treatment of AK can be divided into treatment of solitary lesions (for example with liquid nitrogen) and treatment of an area with multiple AKs, known as ‘field directed treatments’. Frequently prescribed field‐directed treatments are 5‐fluorouracil cream, imiquimod cream, photodynamic therapy (PDT), and ingenol mebutate gel. This study aimed to find out which field‐directed treatment is the most cost‐effective, when comparing 5% 5‐fluorouracil (5‐FU), 5% imiquimod (IMQ), 0.015% ingenol mebutate (IM), and methylaminolevulinate photodynamic therapy (MAL‐PDT) for AK in the head and neck region. 624 patients were included in this study in the Netherlands. Data on effectiveness and all costs (treatment‐related, costs before treatment and costs after treatment) up to 12 months after treatment were obtained and compared. Twelve months after treatment, the total mean costs for 5‐FU were significantly lower (€433), compared to €728, €775 and €1621 for IMQ, IM and MAL‐PDT, respectively. The authors found that 5% 5‐fluorouracil cream was a more effective and less expensive treatment compared to the other treatments, 12 months after treatment. Based on these results, 5% 5‐FU cream can be considered as a first choice treatment option for multiple AK in the head and neck area. Linked Article: Jansen et al. Br J Dermatol 2020; 183: 738–744.