@article{Athanasakis2017-lu,
title = {Cost-effectiveness of Ingenol Mebutate Gel for the Treatment of
Actinic Keratosis in Greece},
author = {Kostas Athanasakis and Nadia Boubouchairopoulou and Filippos Tarantilis and Vasiliki Tsiantou and Stathis Kontodimas and John Kyriopoulos},
year = {2017},
date = {2017-04-01},
journal = {Clin Ther},
volume = {39},
number = {5},
pages = {993--1002},
address = {United States},
abstract = {PURPOSE: The present study aimed to perform a cost-effectiveness
analysis of ingenol mebutate (IM) versus other topical
alternatives for the treatment of actinic keratosis (AK).
METHODS: The analysis used a decision tree to calculate the
clinical effects and costs of AK first-line treatments, IM (2-3
days), diclofenac 3% (for 8 or 12 weeks), imiquimod 5% (for 4
or 8 weeks), during a 24-month horizon, using discrete intervals
of 6 months. A hypothetical cohort of immunocompetent adult
patients with clinically confirmed AK on the face and scalp or
trunk and extremities was considered. Clinical data on the
relative efficacy were obtained from a network meta-analysis.
Inputs concerning resource use derived from an expert panel. All
costs were calculated from a Greek third-party payer perspective.
FINDINGS: IM 0.015% and 0.05% were both cost-effective compared
with diclofenac and below a willingness-to-pay threshold of
€30,000 per quality-adjusted life-year (QALY) (€199 and €167 per
QALY, respectively). Comparing IM on the face and scalp AK
lesions for 3 days versus imiquimod for 4 weeks resulted in an
incremental cost-effectiveness ratio of €10,868 per QALY. IM was
dominant during the 8-week imiquimod period. IM use on the trunk
and extremities compared with diclofenac (8 or 12 weeks) led to
incremental cost-effectiveness ratios estimated at €1584 and
€1316 per QALY accordingly. Results remained robust to
deterministic and probabilistic sensitivity analyses.
IMPLICATIONS: From a social insurance perspective in Greece, IM
0.015% and IM 0.05% could be the most cost-effective first-line
topical field treatment options in all cases for AK treatment.},
keywords = {actinic keratosis; cost; cost-effectiveness; ingenol mebutate; topical treatment},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: The present study aimed to perform a cost-effectiveness
analysis of ingenol mebutate (IM) versus other topical
alternatives for the treatment of actinic keratosis (AK).
METHODS: The analysis used a decision tree to calculate the
clinical effects and costs of AK first-line treatments, IM (2-3
days), diclofenac 3% (for 8 or 12 weeks), imiquimod 5% (for 4
or 8 weeks), during a 24-month horizon, using discrete intervals
of 6 months. A hypothetical cohort of immunocompetent adult
patients with clinically confirmed AK on the face and scalp or
trunk and extremities was considered. Clinical data on the
relative efficacy were obtained from a network meta-analysis.
Inputs concerning resource use derived from an expert panel. All
costs were calculated from a Greek third-party payer perspective.
FINDINGS: IM 0.015% and 0.05% were both cost-effective compared
with diclofenac and below a willingness-to-pay threshold of
€30,000 per quality-adjusted life-year (QALY) (€199 and €167 per
QALY, respectively). Comparing IM on the face and scalp AK
lesions for 3 days versus imiquimod for 4 weeks resulted in an
incremental cost-effectiveness ratio of €10,868 per QALY. IM was
dominant during the 8-week imiquimod period. IM use on the trunk
and extremities compared with diclofenac (8 or 12 weeks) led to
incremental cost-effectiveness ratios estimated at €1584 and
€1316 per QALY accordingly. Results remained robust to
deterministic and probabilistic sensitivity analyses.
IMPLICATIONS: From a social insurance perspective in Greece, IM
0.015% and IM 0.05% could be the most cost-effective first-line
topical field treatment options in all cases for AK treatment.
