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Topical v Systemic Agent Treatment for Papulopustular AcneA Cost-effectiveness Analysis
Robert S. Stern, MD;
Theodore M. Pass, PhD;
Anthony L. Komaroff, MD
Arch Dermatol. 1984;120(12):1571-1578.
Abstract
• We used cost-effectiveness analysis to compare the costs, risks, and benefits of two strategies for clearing papulopustular acne; topical therapy alone as initial therapy or a combination of systemic antibiotics and topical agents used at the first visit. Patients treated with combination therapy had fewer weeks of morbidity from acne, and lower dollar costs but have a greater risk of side effects. If the topical therapy alone was chosen to reduce the risk of side effects in a population of patients there would be an additional $764 in costs and 238 weeks of morbidity from acne to avert a single additional instance of side effects. Initial treatment of papulopustular acne with combined oral antibiotics and topical agents thus seems to be cost-effective. After clearing is achieved, maintenance therapy with topical agents should be considered.
(Arch Dermatol 1984;120:1571-1578)
Author Affiliations
From the Department of Dermatology, Beth Israel Hospital (Dr Stern); the Charles A. Dana Biomedical Institute (Dr Stern); the Institute for Health Research, School of Public Health (Drs Stern, Pass, and Komaroff); and the Laboratory for the Analysis of Medical Practices, Division of General Medicine and Primary Care, Brigham and Women's Hospital (Drs Pass and Komaroff), Boston.
Footnotes
Accepted for publication May 29, 1984.
Reprint requests to Department of Dermatology, Beth Israel Hospital, 330 Brookline Ave, Boston, MA 02215 (Dr Stern).
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