A cost-utility analysis of ingenol mebutate gel for the treatment of actinic keratosis: a Scottish perspective

Tolley, Keith; Kemmett, D; Thybo, Signe; Nasr, R; Smethurst, Helen

doi:10.1007/s10198-015-0679-8

Cited by 12 publications

(9 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pharmacoeconomic calculations (e.g. 29,44,45 ) using either standard gamble or TTO methodology resulted in utilities of 0.99 and 0.98. 46,47 However, these two studies included a total number of 25 patients and were not specific for AK but for a broad variety of dermatological conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, in their recent structured review on PROMs, authors from the United Kingdom expressed the need to analyse NMSC QL using a common standardised instrument and recommended the implementation of EQ‐5D in this disease spectrum . The EQ Index in particular represents a very robust outcome measure that can also be implemented in the calculation of quality‐adjusted life years (QALYs) in future health economic evaluations of NMSC treatments …”

Section: Introductionmentioning

confidence: 99%

“…26,27 The EQ Index in particular represents a very robust outcome measure 28 that can also be implemented in the calculation of qualityadjusted life years (QALYs) in future health economic evaluations of NMSC treatments. 29 This study included patients with NMSC and AK and was designed to elucidate whether the proposed disease continuum is also accompanied by impairment in QL.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Patient‐reported health outcomes in patients with non‐melanoma skin cancer and actinic keratosis: results from a large‐scale observational study analysing effects of diagnoses and disease progression

Philipp‐Dormston¹,

Müller

Novak

et al. 2018

Acad Dermatol Venereol

View full text Add to dashboard Cite

BackgroundNon‐melanoma skin cancer (NMSC) and actinic keratosis (AK) are very common among fair‐skinned individuals. A disease continuum from AK to squamous cell carcinoma (SCC) has been frequently postulated. AK and NMSC may influence quality of life (QL) of patients, and it can be suspected that disease progression entails a QL reduction. The purpose of this study was to document QL in patients with NMSC and AK using the health‐outcome questionnaire EQ‐5D‐5L.MethodsThe study was designed as a non‐interventional, prospective, cross‐sectional study. Patients with AK, SCC, basal cell carcinoma (BCC) or multiple diagnoses were enrolled in this study in 29 dermatological centres across Germany. Patients were asked to complete the EQ‐5D‐5L (compromising EQ Index and EQ VAS), and the dermatologists provided diagnosis, disease history and treatment data.ResultsA total of 1184 patients were enrolled and diagnosed as follows: 73% AK, 49% BCC and 17% SCC. 66% had a single diagnosis, 28% two different diagnoses and 6% three different diagnoses. QL was strongly associated with patients’ diagnosis. Patients with a single AK diagnosis had significantly higher mean EQ VAS (78) than patients with BCC (74), SCC (72), and BCC plus SCC (69), P < 0.050. When the effects of disease progression were calculated, patients with AK plus SCC reported significantly less mean EQ VAS (71) than patients with a single AK diagnosis (78), P < 0.011.ConclusionsWhile rarely being imminently life‐threatening, NMSC and AK have an impact on QL as quantified by the EQ‐5D‐5L. This impact is associated with diagnosis (AK vs. NMSC) and clinical progression (AK vs. AK plus SCC). Both lead to a clear decline in QL. This shows that disease progression is perceived and judged as detrimental by patients and that AK and NMSC should be diligently treated to preserve and restore QL.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Patient‐reported health outcomes in patients with non‐melanoma skin cancer and actinic keratosis: results from a large‐scale observational study analysing effects of diagnoses and disease progression

Philipp‐Dormston¹,

Müller

Novak

et al. 2018

Acad Dermatol Venereol

View full text Add to dashboard Cite

show abstract

“…Phase 3 studies showed its efficiency in clearing AK, with sustained clearance over 12 months, using concentrations of 0.015% for face and scalp and 0.05% for trunk and extremities [111]. There is evidence to suggest that IM has higher efficacy than diclofenac 3% and IMQ 5% in the treatment of AK [120].…”

Section: Introductionmentioning

confidence: 99%

Mediators of Inflammation in Topical Therapy of Skin Cancers

Voiculescu

Lisievici

Lupu

et al. 2019

Mediators of Inflammation

View full text Add to dashboard Cite

Taking into consideration that the immune system plays a very important role in the development of melanoma and non-melanoma skin cancers, which have a high prevalence in immunosuppressed patients and after prolonged ultraviolet radiation, the interest in developing novel therapies, in particular targeting the inflammation in cancer, has increased in the past years. The latest data suggest that therapies such as imiquimod (IMQ), ingenol mebutate (IM), 5-fluorouracil (5-FU), retinoids, and nonsteroidal anti-inflammatory drugs (NSAIDs) have been used with success in the topical treatment of some cancers. Herein, we review the topical treatment targeting the inflammation in skin cancer and the mechanisms involved in these processes. Currently, various associations have shown a superior success rate than monotherapy, such as systemic acitretin and topical IMQ, topical 5-FU with tretinoin cream, or IMQ with checkpoint inhibitor cytotoxic T lymphocyte antigen 4. Novel therapies targeting Toll-like receptor-7 (TLR-7) with higher selectivity than IMQ are also of great interest.

show abstract

“…Numerous studies have reported the efficacy of the topically applied gel in the field therapy of AKs and its effect on the clearance of both clinically evident and subclinical lesions [10,12,31,35]. In a long-term follow-up study, Garbe et al [36] reported a persisting clinical clearance in 50% of the patients after 12 months.…”

Section: Discussionmentioning

confidence: 99%

Non‐invasive monitoring of subclinical and clinical actinic keratosis of face and scalp under topical treatment with ingenol mebutate gel 150 mcg/g by means of reflectance confocal microscopy and optical coherence tomography: New perspectives and comparison of diagnostic techniques

Ruini

Hartmann

Bastian

et al. 2019

Journal of Biophotonics

View full text Add to dashboard Cite

Actinic keratosis (AK) corresponds to the earliest stage of in situ squamous cell carcinoma and arises on chronically sun‐exposed skin. Around the clinically evident AKs, the apparently healthy epidermis may contain different grades of atypia that can be detected by noninvasive imaging techniques such as reflectance confocal microscopy (RCM) and optical coherence tomography (OCT). Subclinical actinic keratosis (sAK) has captured increasing interest as a potential target of field therapies. The aim of this study was to evaluate in vivo the changes in the field cancerization undergoing treatment with topical ingenol mebutate by combining RCM and OCT. Twenty patients with field cancerization of the face and scalp were treated with ingenol mebutate gel (150 mcg/g) for three consecutive days on an area of 25 cm2 containing at least two AKs, two sAKs and two apparently healthy sites. About 120 lesions were evaluated through clinical investigation and clinical, dermoscopical, RCM and OCT images at day 0, 4, 14 and 56 based on the diagnostic criteria for AKs. Main pathological features improved in both AKs and sAKs, in particular the epidermal thickness measured by OCT and the epidermal atypia graded by RCM. Local skin reactions (LSR) arose predominantly in the lesional area compared with healthy skin. A complete clearance was detected in 58% for AKs, and in 55% and 72% for sAKs measured by RCM and OCT, respectively. Both OCT and RCM allow the morphological representation of field cancerization including subclinical lesions and provide complementary information. Ingenol mebutate is effective not only in clinically evident but also in sAKs. The differences in LSR highlight the potential selectivity of the treatment.

show abstract

A cost-utility analysis of ingenol mebutate gel for the treatment of actinic keratosis: a Scottish perspective

Abstract: Ingenol mebutate gel is a cost-effective therapy for the first-line treatment of AK from a Scottish NHS perspective.

Cited by 12 publications

References 22 publications

Patient‐reported health outcomes in patients with non‐melanoma skin cancer and actinic keratosis: results from a large‐scale observational study analysing effects of diagnoses and disease progression

Patient‐reported health outcomes in patients with non‐melanoma skin cancer and actinic keratosis: results from a large‐scale observational study analysing effects of diagnoses and disease progression

Mediators of Inflammation in Topical Therapy of Skin Cancers

Non‐invasive monitoring of subclinical and clinical actinic keratosis of face and scalp under topical treatment with ingenol mebutate gel 150 mcg/g by means of reflectance confocal microscopy and optical coherence tomography: New perspectives and comparison of diagnostic techniques

Contact Info

Product

Resources

About