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For 5% imiquimod, the incremental cost/effectiveness ratio indicates only a modest effectiveness gain at an added cost of EUR 7.94, making it less cost-effective.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},331503,1790090274,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,111,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":108,"show_sort_weight":109,"slug":110},7,"Healthcare",40,"healthcare",{"id":112,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":113,"slug":114},8,30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":112,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":55,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},1374391974468,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Article  \nCost-Effectiveness Analysis of Topical Treatments for Actinic Keratosis in Italian National Health System  \nMariafrancesca Hyeraci *,†, Gianluca Pistore †, Francesco Ricci , Francesco Moro, Giovanni Di Lella, Elena Dellambra , Damiano Abeni and Luca Fania  \nCitation: Hyeraci, M.; Pistore, G.; Ricci, F.; Moro, F.; Lella, G.D.;  \nDellambra, E.; Abeni, D.; Fania, L. Cost-Effectiveness Analysis of Topical Treatments for Actinic Keratosis in Italian National Health System. J. Clin. Med. 2024, 13, 6312. [https://](https://)[ ](https://)[doi.org/10.3390/jcm13216312](doi.org/10.3390/jcm13216312)  \nAcademic Editor: Guy Orchard  \nReceived: 19 August 2024  \nRevised: 11 October 2024  \nAccepted: 18 October 2024  \nPublished: 22 October 2024  \nCopyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \nIDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy;  \n[gianluca@gianlucapistore.com](gianluca@gianlucapistore.com) (G.P.); [f.ricci@idi.it](f.ricci@idi.it) (F.R.); [f.moro@idi.it](f.moro@idi.it) (F.M.); [g.dilella@idi.it](g.dilella@idi.it) (G.D.L.);  \n[e.dellambra@idi.it](e.dellambra@idi.it) (E.D.); [d.abeni@idi.it](d.abeni@idi.it) (D.A.); [l.fania@idi.it](l.fania@idi.it) (L.F.)  \n* [Correspondence: mariafrancesca.hyeraci@gmail.com](Correspondence: mariafrancesca.hyeraci@gmail.com)  \n† These authors contributed equally to this work.  \nAbstract: Introduction: Actinic keratosis (AK) is a widespread pre-cancerous skin condition that may evolve to squamous cell carcinoma, a non-melanoma skin cancer, which is able to become locally invasive and metastatic. Thus, it is important to treat AK. Methods: We conducted a costeffectiveness analysis for the field-directed therapeutic approaches: local application of drugs containing 5-fluorouracil, both alone at a 4% concentration and associated to 10% salicylic acid at a 0.5% concentration (0.5% 5-FU + 10% SA cut. sol.); diclofenac-hyaluronic acid gel; imiquimod, both at 3.75% and 5%(5% IMQ cream) concentrations; and tirbanibulin ointment. The effectiveness data were abstracted from the literature. The cost-effectiveness analysis was performed by considering the prices reported by Agenzia Italiana del Farmaco (AIFA) for each medicine. Results: We obtained the total cost for each treatment by computing the cost of a single treatment for its duration. Application of 0.5% 5-FU + 10% SA cut. sol. appeared as the most convenient approach, as it was more effective and less expensive than all treatments except for 5% IMQ cream. For this last option, the incremental cost/effectiveness ratio analysis showed that a modest gain in effectiveness has a cost of EUR 7.94, therefore making it less cost effective.  \nKeywords: actinic keratosis; cost-effectiveness; Italian healthcare system; 5-fluorouracil; diclofenac; imiquimod; tirbanibulin  \n1. Introduction  \nActinic keratosis (AK) is a very common pre-cancerous lesion arising from the abnormal proliferation of keratinocytes in skin areas chronically damaged by exposure to ultraviolet (UV) rays, affecting about 40% of the adult population [1,2] . In the light spectrum, wavelengths corresponding to UV-B (290–320 nm) are considered as the most damaging for skin health, and the ozone layer is reported as the main natural filter of UV-B light. Unfortunately, the thickness of ozone layer is gradually reducing, and this event represents the main cause of the continuously increasing incidence of AK disease [3] . The main risk factors for AK include exposure to UV rays, age, male sex, Fitzpatrick skin type I–II, immunosuppression, and previous diagnosis of AK or non-melanoma skin cancer (NMSC) . On the contrary, the use of both topic a","cbCaijBloX7AUuLB","https://ap.wps.com/l/cbCaijBloX7AUuLB","pdf",256459,"English","# Introduction\n## Disease background and risks\n## Therapeutic approaches\n# Methods\n## Treatments assessed\n## Effectiveness and cost inputs\n# Results\n## Cost-effectiveness comparisons","[{\"question\":\"What is the purpose of the study on AK topical treatments?\",\"answer\":\"To evaluate which topical therapies for actinic keratosis are most cost-effective within the Italian National Health System.\"},{\"question\":\"Which treatments were included in the cost-effectiveness analysis?\",\"answer\":\"The analysis covers 0.5% 5-fluorouracil plus 10% salicylic acid (0.5% 5-FU + 10% SA), 5-fluorouracil formulations, diclofenac-hyaluronic acid gel, imiquimod at 3.75% and 5%, and tirbanibulin ointment.\"},{\"question\":\"Which approach was found to be most convenient and how did 5% imiquimod compare?\",\"answer\":\"The 0.5% 5-FU + 10% SA cut. sol. combination was more effective and less expensive than all treatments except 5% imiquimod. For 5% imiquimod, the incremental cost/effectiveness ratio indicates only a modest effectiveness gain at an added cost of EUR 7.94, making it less cost-effective.\"}]","Cost-Effectiveness Analysis of Topical Treatments for Actinic Keratosis in Italian National Health System | PDF",1789993624,28]