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Cost-effectiveness of topical pharmacological, oral pharmacological, physical and combined treatments for acne vulgaris

Cost-effectiveness of topical pharmacological, oral pharmacological, physical and combined treatments for acne vulgaris
Cost-effectiveness of topical pharmacological, oral pharmacological, physical and combined treatments for acne vulgaris
Background. Acne vulgaris is a common skin condition that may cause psychoso-cial distress. There is evidence that topical treatment combinations, chemical peels and photochemical therapy (combined blue/red light) are effective for mild-to-moderate acne, while topical treatment combinations, oral antibiotics combined with topical treatments, oral isotretinoin and photodynamic therapy are most effective for moderate-to-severe acne. Effective treatments have varying costs. The National Institute for Health and Care Excellence (NICE) in England considers cost-effectiveness when producing national clinical, public health and social care guidance.

Aim: To assess the cost-effectiveness of treatments for mild-to-moderate and moderate-to-severe acne to inform relevant NICE guidance.

Methods: A decision–analytical model compared costs and quality-adjusted life-years (QALYs) of effective topical pharmacological, oral pharmacological, physical and combined treatments for mild-to-moderate and moderate-to-severe acne, from the perspective of the National Health Service in England. Effectiveness data were derived from a network meta-analysis. Other model input parameters were based on published sources, supplemented by expert opinion.

Results: All of the assessed treatments were more cost-effective than treatment with placebo (general practitioner visits without active treatment). For mild-to-moderate acne, topical treatment combinations and photochemical therapy (com-bined blue/red light) were most cost-effective. For moderate-to-severe acne, topical treatment combinations, oral antibiotics combined with topical treatments, and oral isotretinoin were the most cost-effective. Results showed uncertainty, as reflected in the wide confidence intervals around mean treatment rankings.


Conclusion: A range of treatments are cost-effective for the management of acne. Well-conducted studies are needed to examine the long-term clinical efficacy and cost-effectiveness of the full range of acne treatments.
0307-6938
2176–2187
Mavranezouli, Ifigeneia
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Welton, Nicky J.
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Daly, Caitlin H.
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Wilcock, Jane
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Bromham, Nathan
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Berg, Laura
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Xu, Jingyuan
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Wood, Damien
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Ravenscroft, Jane C.
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Dworzynski, Katharina
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Healy, Eugene
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Mavranezouli, Ifigeneia
971b821a-c12d-404d-8e51-a06644db63a1
Welton, Nicky J.
0af4518d-a999-469c-a46c-4a77fea140aa
Daly, Caitlin H.
a861fc8d-7883-4d31-a419-24afae4c0bf9
Wilcock, Jane
3139a824-177f-403e-b283-cac430ef23ed
Bromham, Nathan
53db1928-da4c-4102-b51d-dc8c940bbca8
Berg, Laura
f1035a47-7c19-4bab-aa24-a91950620a3b
Xu, Jingyuan
6861a1d6-145f-41a3-80a4-9d362f869eae
Wood, Damien
a3319086-a02f-4737-a303-0a20cf234850
Ravenscroft, Jane C.
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Dworzynski, Katharina
e8a6aa72-c6b1-4971-b416-396448a5e9f8
Healy, Eugene
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Mavranezouli, Ifigeneia, Welton, Nicky J., Daly, Caitlin H., Wilcock, Jane, Bromham, Nathan, Berg, Laura, Xu, Jingyuan, Wood, Damien, Ravenscroft, Jane C., Dworzynski, Katharina and Healy, Eugene (2022) Cost-effectiveness of topical pharmacological, oral pharmacological, physical and combined treatments for acne vulgaris. Clinical and Experimental Dermatology, 47 (12), 2176–2187. (doi:10.1111/ced.15356).

Record type: Article

Abstract

Background. Acne vulgaris is a common skin condition that may cause psychoso-cial distress. There is evidence that topical treatment combinations, chemical peels and photochemical therapy (combined blue/red light) are effective for mild-to-moderate acne, while topical treatment combinations, oral antibiotics combined with topical treatments, oral isotretinoin and photodynamic therapy are most effective for moderate-to-severe acne. Effective treatments have varying costs. The National Institute for Health and Care Excellence (NICE) in England considers cost-effectiveness when producing national clinical, public health and social care guidance.

Aim: To assess the cost-effectiveness of treatments for mild-to-moderate and moderate-to-severe acne to inform relevant NICE guidance.

Methods: A decision–analytical model compared costs and quality-adjusted life-years (QALYs) of effective topical pharmacological, oral pharmacological, physical and combined treatments for mild-to-moderate and moderate-to-severe acne, from the perspective of the National Health Service in England. Effectiveness data were derived from a network meta-analysis. Other model input parameters were based on published sources, supplemented by expert opinion.

Results: All of the assessed treatments were more cost-effective than treatment with placebo (general practitioner visits without active treatment). For mild-to-moderate acne, topical treatment combinations and photochemical therapy (com-bined blue/red light) were most cost-effective. For moderate-to-severe acne, topical treatment combinations, oral antibiotics combined with topical treatments, and oral isotretinoin were the most cost-effective. Results showed uncertainty, as reflected in the wide confidence intervals around mean treatment rankings.


Conclusion: A range of treatments are cost-effective for the management of acne. Well-conducted studies are needed to examine the long-term clinical efficacy and cost-effectiveness of the full range of acne treatments.

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Clin Experimental Derm - 2022 - Mavranezouli - Cost‐effectiveness of topical pharmacological oral pharmacological - Version of Record
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Accepted/In Press date: 25 July 2022
e-pub ahead of print date: 18 October 2022
Published date: 1 December 2022
Additional Information: Funding Information: This work was undertaken by the National Guideline Alliance (NGA) at the Royal College of Obstetricians and Gynaecologists (RCOG), with support from the National Institute for Health and Care Excellence (NICE) Guidelines Technical Support Unit (TSU), University of Bristol, which is funded by the NICE Centre for Guidelines. NGA has received funding from NICE to develop clinical, public health and social care guidelines. For the development of this guideline, NICE worked with the British Association of Dermatologists. The views expressed in this publication are those of the authors and not necessarily those of RCOG, NGA or NICE. The funder of the study had no further role in the study design, data collection, data analysis, data interpretation, or writing of the report. All authors had full access to all the data in the study and had final responsibility for the decision to submit for publication. National Institute for Health and Care Excellence (2021) Acne Vulgaris: management. Available from: https://nice.org.uk/guidance/ng198. We thank Stephanie Arnold for conducting the systematic search of the literature on acne health state utility values and economic evaluations of acne treatments, and Shalmali Deshpande for contributing to data collection and synthesis. We also thank other members of the Guideline Committee for the NICE guideline on ‘Acne vulgaris: management’ for their contributions to this work. The members of the Committee were: Julia Cons (chair), Eugene Healy (topic advisor), Jack Higgins, Karen Joy, Sarah Mackenzie, Rebecca Penzer-Hick, Mohammed Rafiq, Jane Ravenscroft, Julia Schofield (until March 2020), Jane Wilcock and Damian Wood; co-opted members: Colin Duncan, Priya Khanna, Guy Northover, Ursula Philpot, Reena Shah and Neil Walker. Funding Information: This work was undertaken by the National Guideline Alliance (NGA) at the Royal College of Obstetricians and Gynaecologists (RCOG), with support from the National Institute for Health and Care Excellence (NICE) Guidelines Technical Support Unit (TSU), University of Bristol, which is funded by the NICE Centre for Guidelines. NGA has received funding from NICE to develop clinical, public health and social care guidelines. For the development of this guideline, NICE worked with the British Association of Dermatologists. The views expressed in this publication are those of the authors and not necessarily those of RCOG, NGA or NICE. The funder of the study had no further role in the study design, data collection, data analysis, data interpretation, or writing of the report. All authors had full access to all the data in the study and had final responsibility for the decision to submit for publication. National Institute for Health and Care Excellence (2021) Acne Vulgaris: management. Available from: https://nice.org.uk/guidance/ng198 . Publisher Copyright: © 2022 The Authors. Clinical and Experimental Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

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Local EPrints ID: 472985
URI: http://eprints.soton.ac.uk/id/eprint/472985
ISSN: 0307-6938
PURE UUID: 7c50b5dc-40eb-4a53-ae61-138b7027cacb

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Date deposited: 06 Jan 2023 17:36
Last modified: 16 Mar 2024 23:29

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Contributors

Author: Ifigeneia Mavranezouli
Author: Nicky J. Welton
Author: Caitlin H. Daly
Author: Jane Wilcock
Author: Nathan Bromham
Author: Laura Berg
Author: Jingyuan Xu
Author: Damien Wood
Author: Jane C. Ravenscroft
Author: Katharina Dworzynski
Author: Eugene Healy

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