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.

中文翻译：

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氟尿嘧啶外用霜对治疗角质形成细胞癌（非黑素瘤皮肤癌）和光化性角化病费用的影响

背景

尚不清楚是否可以通过在化学预防上花费更多的钱来降低角质形成细胞癌（KC）和光化性角化病（AK）的治疗费用。

客观的

为了研究局部氟尿嘧啶（5-FU）的1疗程对面部和耳朵的影响，对3年内KC和AK的治疗费用的影响。

方法

退伍军人事务角质形成细胞癌化学预防试验比较了局部5-FU 5％与溶媒对照乳膏降低KC风险的功效。分析了有关费用和利用率的试验数据和行政数据，以衡量随机分配后遇到的情况以及KC和AK护理的治疗费用。调整后的模型用于测试各治疗组之间在治疗次数和费用方面的统计学显着性差异。

结果

随机分组后一年，对照组患鳞状细胞癌的平均治疗次数（0.04）高于干预组（0.01）（P  <.01）。在1年时，干预组的治疗和皮肤病学费用较低：对照组为2106美元（标准差，2079美元），而对照组为2444美元（标准差，2716美元）（P  = .02）。3年后，干预部门每位患者的费用减少了$ 771。

局限性

不包括退伍军人事务部未提供或未支付的护理。结果可能无法推广到其他付款人。

结论

我们发现用5-FU治疗的患者可节省大量成本。