Pharmacoeconomy of drugs used in the treatment of actinic keratoses

Nisticò, Steven Paul; Torchia, V; Gliozzi, Micaela; Bottoni, Ugo; Duca, Ester Del; Muscoli, Carolina

doi:10.1177/0394632016648707

Cited by 8 publications

(17 citation statements)

References 29 publications

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“…As there was little difference in quality-adjusted life-years per patient between the two treatments, the analysis interpreted this as an additional cost of €19.65 to treat a patient with ingenol mebutate, with no additional benefit over diclofenac by assuming equal efficacy. 23 These findings diverge from previous publications on the relative efficacy and cost-effectiveness of ingenol mebutate. However, we offer a critique of this new pharmacoeconomic analysis.…”

Section: Discussioncontrasting

confidence: 64%

“…A pharmacoeconomic analysis of 3% diclofenac sodium versus 0.015% ingenol mebutate in the treatment of AK, from an Italian Healthcare System perspective, reported that diclofenac was more cost-effective than ingenol mebutate. 23 Estimated total costs over 12 months for treating 500 patients with diclofenac were €82.594 versus €95.416 for ingenol mebutate. As there was little difference in quality-adjusted life-years per patient between the two treatments, the analysis interpreted this as an additional cost of €19.65 to treat a patient with ingenol mebutate, with no additional benefit over diclofenac by assuming equal efficacy.…”

Section: Discussionmentioning

confidence: 99%

“…The efficacy of ingenol mebutate has previously been established in large, randomised, placebo-controlled trials. In the recent analysis, 23 four placebo-controlled trials involving 1,142 patients were used to estimate the efficacy. 24 In contrast, estimates of diclofenac efficacy were based on one, phase IV, open-label trial involving 76 patients, of which 52 patients completed a 12-month follow-up.…”

Section: Discussionmentioning

confidence: 99%

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Pharmacoeconomic evaluations in the treatment of actinic keratoses

Tolley

Argenziano

Calzavara-Pinton

et al. 2017

Int J Immunopathol Pharmacol

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Actinic keratoses (AKs) develop as a consequence of chronic ultraviolet (UV) exposure and exist on a continuum with squamous cell carcinoma (SCC). As one of the most common conditions treated by dermatologists, AK places a significant burden on patients and the healthcare system. A range of treatments are used, including topical treatments that target the visible and subclinical lesions. The goal of such therapies is to achieve complete clearance of AKs and eliminate the risk of progression to SCC. Robust meta-analyses of trial data can provide valuable information for the optimal management of AK and cost-effectiveness evaluations of topical treatments, such as ingenol mebutate gel and diclofenac. These outcomes can facilitate prescribing physicians’ decisions and shape therapeutic guidelines. Peer-reviewed meta-analysis publications and treatment guidelines favoured ingenol mebutate efficacy over diclofenac and the relative cost-effectiveness of ingenol mebutate. We discuss and critique recent evidence, from a cost-effectiveness analysis of 3% diclofenac sodium and ingenol mebutate in the treatment of AK in Italy, which has challenged this view.

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pharmacoeconomic evaluations in the treatment of actinic keratoses

Tolley

Argenziano

Calzavara-Pinton

et al. 2017

Int J Immunopathol Pharmacol

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“…It also initiates apoptosis through activation of bcl-2 and caspase 8 [ 19 ]. There are new studies about effectiveness of diclofenac in AK treatment [ 20 – 22 ].…”

Section: Introductionmentioning

confidence: 99%

The effect of wool hydrolysates on squamous cell carcinoma cells in vitro. Possible implications for cancer treatment

et al. 2017

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Squamous cell carcinoma of the skin is the second most common cutaneous malignancy. Despite various available treatment methods and advances in noninvasive diagnostic techniques, the incidence of metastatic cutaneous squamous cell carcinoma is rising. Deficiency in effective preventive or treatment methods of transformed keratinocytes leads to necessity of searching for new anticancer agents. The present study aims to evaluate the possibility of using wool hydrolysates as such agents. Commercially available compounds such as 5-fluorouracil, ingenol mebutate, diclofenac sodium salt were also used in this study. The process of wool degradation was based on chemical pre-activation and enzymatic digestion of wool. The effect of mentioned compounds on cell viability of squamous carcinoma cell line and healthy keratinocytes was evaluated. The obtained data show a significantly stronger effect of selected wool hydrolysates compared to commercial compounds (p<0.05) on viability of cells. The wool hydrolysates decreased squamous cell carcinoma cells viability by up to 67% comparing to untreated cells. These results indicate bioactive properties of wool hydrolysates, which affect the viability of squamous carcinoma cells and decrease their number. We hypothesize that these agents may be used topically for treatment of transformed keratinocytes in actinic keratosis and invasive squamous skin cancer in humans.

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“…This study highlights the importance of cost considerations when a treatment decision is made. Other analyses were mainly based on decision tree models using previously published data, which may not be sufficient to reproduce the treatment costs in a real‐world setting . Nevertheless, the generalizability of the results is limited as costs for topical drugs and reimbursement modalities are highly variable in a country‐specific context .…”

mentioning

confidence: 99%