Field therapies for actinic keratosis: an Australian cost‐effectiveness analysis
Abstract Background Actinic keratoses have a high prevalence in the older Australian population, with most patients presenting with field actinic damage. Despite this high prevalence, no field therapies are subsidised under the Pharmaceutical Benefits Scheme. Objectives To determine which therapy fo...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-03-01
|
| Series: | JEADV Clinical Practice |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jvc2.564 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850099063085596672 |
|---|---|
| author | Yaron Gu Kinar Mistry Shah Grace Xiaoying Li Deshan Frank Sebaratnam Helen Yiling Sun |
| author_facet | Yaron Gu Kinar Mistry Shah Grace Xiaoying Li Deshan Frank Sebaratnam Helen Yiling Sun |
| author_sort | Yaron Gu |
| collection | DOAJ |
| description | Abstract Background Actinic keratoses have a high prevalence in the older Australian population, with most patients presenting with field actinic damage. Despite this high prevalence, no field therapies are subsidised under the Pharmaceutical Benefits Scheme. Objectives To determine which therapy for field actinic damage is the most cost‐effective when comparing 5‐fluorouracil (5‐FU), imiquimod (IMQ), and methyl‐aminolevulinate photodynamic therapy (MAL‐PDT) at 12 months post‐treatment. Methods A decision tree was constructed using TreeAge Pro, representing the likely clinical trajectories of patients with field actinic damage treated with 5‐FU, IMQ, and MAL‐PDT. The cost‐effectiveness analysis was performed from the patient perspective, assuming an outpatient setting. Efficacy data was derived from a single‐blinded, multi‐centre prospective randomised control trial. Cost data were derived from Australian dermatology clinics and pharmacies. One‐way and probabilistic sensitivity analyses were conducted. Results 5‐FU was the most cost‐effective treatment. It was cheaper and more effective than all other treatments, with a cost‐effectiveness ratio of AU$201 per patient achieving ≥75% clearance in field actinic damage. The cost‐effectiveness ratios of IMQ, and MAL‐PDT were AU$940, and AU$8058 per patient achieving ≥75% clearance respectively. Both sensitivity analyses showed certainty in 5‐FU's dominance over the other treatments. Conclusions 5‐FU is the most cost‐effective treatment option for Australian patients presenting with actinic field damage on the head area. |
| format | Article |
| id | doaj-art-b43aa097af10412d9d0c701cf7040dd2 |
| institution | DOAJ |
| issn | 2768-6566 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | JEADV Clinical Practice |
| spelling | doaj-art-b43aa097af10412d9d0c701cf7040dd22025-08-20T02:40:33ZengWileyJEADV Clinical Practice2768-65662025-03-014113714410.1002/jvc2.564Field therapies for actinic keratosis: an Australian cost‐effectiveness analysisYaron Gu0Kinar Mistry Shah1Grace Xiaoying Li2Deshan Frank Sebaratnam3Helen Yiling Sun4School of Clinical Medicine, UNSW Medicine & Health, South West Sydney Clinical Campuses, Faculty of Medicine and Health, UNSW Sydney New South Wales AustraliaSchool of Clinical Medicine, UNSW Medicine & Health, South West Sydney Clinical Campuses, Faculty of Medicine and Health, UNSW Sydney New South Wales AustraliaSchool of Clinical Medicine, UNSW Medicine & Health, South West Sydney Clinical Campuses, Faculty of Medicine and Health, UNSW Sydney New South Wales AustraliaSchool of Clinical Medicine, UNSW Medicine & Health, South West Sydney Clinical Campuses, Faculty of Medicine and Health, UNSW Sydney New South Wales AustraliaSchool of Clinical Medicine, UNSW Medicine & Health, South West Sydney Clinical Campuses, Faculty of Medicine and Health, UNSW Sydney New South Wales AustraliaAbstract Background Actinic keratoses have a high prevalence in the older Australian population, with most patients presenting with field actinic damage. Despite this high prevalence, no field therapies are subsidised under the Pharmaceutical Benefits Scheme. Objectives To determine which therapy for field actinic damage is the most cost‐effective when comparing 5‐fluorouracil (5‐FU), imiquimod (IMQ), and methyl‐aminolevulinate photodynamic therapy (MAL‐PDT) at 12 months post‐treatment. Methods A decision tree was constructed using TreeAge Pro, representing the likely clinical trajectories of patients with field actinic damage treated with 5‐FU, IMQ, and MAL‐PDT. The cost‐effectiveness analysis was performed from the patient perspective, assuming an outpatient setting. Efficacy data was derived from a single‐blinded, multi‐centre prospective randomised control trial. Cost data were derived from Australian dermatology clinics and pharmacies. One‐way and probabilistic sensitivity analyses were conducted. Results 5‐FU was the most cost‐effective treatment. It was cheaper and more effective than all other treatments, with a cost‐effectiveness ratio of AU$201 per patient achieving ≥75% clearance in field actinic damage. The cost‐effectiveness ratios of IMQ, and MAL‐PDT were AU$940, and AU$8058 per patient achieving ≥75% clearance respectively. Both sensitivity analyses showed certainty in 5‐FU's dominance over the other treatments. Conclusions 5‐FU is the most cost‐effective treatment option for Australian patients presenting with actinic field damage on the head area.https://doi.org/10.1002/jvc2.564actinic keratosiscost‐effectivenesscost‐utilityfield therapyhealth economics |
| spellingShingle | Yaron Gu Kinar Mistry Shah Grace Xiaoying Li Deshan Frank Sebaratnam Helen Yiling Sun Field therapies for actinic keratosis: an Australian cost‐effectiveness analysis JEADV Clinical Practice actinic keratosis cost‐effectiveness cost‐utility field therapy health economics |
| title | Field therapies for actinic keratosis: an Australian cost‐effectiveness analysis |
| title_full | Field therapies for actinic keratosis: an Australian cost‐effectiveness analysis |
| title_fullStr | Field therapies for actinic keratosis: an Australian cost‐effectiveness analysis |
| title_full_unstemmed | Field therapies for actinic keratosis: an Australian cost‐effectiveness analysis |
| title_short | Field therapies for actinic keratosis: an Australian cost‐effectiveness analysis |
| title_sort | field therapies for actinic keratosis an australian cost effectiveness analysis |
| topic | actinic keratosis cost‐effectiveness cost‐utility field therapy health economics |
| url | https://doi.org/10.1002/jvc2.564 |
| work_keys_str_mv | AT yarongu fieldtherapiesforactinickeratosisanaustraliancosteffectivenessanalysis AT kinarmistryshah fieldtherapiesforactinickeratosisanaustraliancosteffectivenessanalysis AT gracexiaoyingli fieldtherapiesforactinickeratosisanaustraliancosteffectivenessanalysis AT deshanfranksebaratnam fieldtherapiesforactinickeratosisanaustraliancosteffectivenessanalysis AT helenyilingsun fieldtherapiesforactinickeratosisanaustraliancosteffectivenessanalysis |