Impact of topical fluorouracil cream on costs of treating keratinocyte carcinoma (nonmelanoma skin cancer) and actinic keratosis - 16/08/18
, Ciaran S. Phibbs, PhD a, b, d, Adam Chow, BA a, Martin A. Weinstock, MD, PhD e, f, g, hfor the
Veterans Affairs Keratinocyte Carcinoma Chemoprevention Trial Group
Abstract |
Background |
It is unknown whether treatment costs for keratinocyte carcinoma (KC) and actinic keratosis (AK) can be lowered by spending more on chemoprevention.
Objective |
To examine the impact of 1-course treatment with topical fluorouracil (5-FU) on the face and ears on KC and AK treatment costs over 3 years.
Methods |
The Veterans Affairs Keratinocyte Carcinoma Chemoprevention trial compared the efficacy of topical 5-FU 5% with that of vehicle control cream for reducing KC risk. Trial data and administrative data on costs and utilization were analyzed to measure postrandomization encounters and treatment costs for KC and AK care. Adjusted models were used to test for statistically significant differences between treatment arms for number of treatment encounters and costs.
Results |
One year after randomization, the control arm had a higher mean number of treatment encounters for squamous cell carcinoma (0.04) than the intervention arm (0.01) (P < .01). At 1 year, the intervention arm had lower treatment and dermatologic costs: $2106 (standard deviation, $2079) compared with $2444 (standard deviation, $2716) for the control patients (P = .02). After 3 years, the intervention arm incurred a cost of $771 less per patient.
Limitations |
Care not provided or paid for by the Department of Veterans Affairs was not included. Results may not be generalizable to other payers.
Conclusion |
We found significant cost savings for patients treated with 5-FU.
Le texte complet de cet article est disponible en PDF.Key words : actinic keratosis, basal cell carcinoma, costs, squamous cell carcinoma, squamous cell carcinoma in situ, veterans
Abbreviations used : AK, BCC, FSS, 5-FU, GLM, KC, SCC, SCCIS, SD, VAKCC, VHA
Plan
| Funding sources: Supported by a Cooperative Studies Program (CSP) grant for CSP study #562 from the Veterans Affairs Cooperative Studies Program, Office of Research and Development, Department of Veterans Affairs. |
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| Disclosure: Dr Weinstock is employed by University Dermatology Inc (Brown University Department of Dermatology's faculty practice), and he has served as a consultant to AbbVie, Castle, Celgene, Melafind, Merck, Palatin Technologies, and the Personal Care Products Council. Dr Yoon, Dr Phibbs, and Mr Chow have no conflicts of interest to disclose. |
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| Dr Yoon and Mr Chow had full access to all of the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. Drs Yoon, Phibbs, and Weinstock were responsible for the study concept and design. Dr Yoon, Dr Phibbs, Mr Chow, and Dr Weinstock were responsible for acquisition, analysis, and interpretation of the data. Dr Yoon was responsible for drafting of the manuscript, and Dr Phibbs, Mr Chow, and Dr Weinstock were responsible for critical revision of the manuscript for important intellectual content. Dr Yoon and Mr Chow were responsible for statistical analysis. Drs Weinstock and Phibbs obtained funding. Drs Weinstock, Yoon, and Phibbs were responsible for administrative, technical, or material support: and Drs Yoon and Weinstock were responsible for study supervision. |
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| The contents do not represent the views of the US Department of Veterans Affairs or the United States Government. |
Vol 79 - N° 3
P. 501 - septembre 2018 Retour au numéro
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