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December 1984

Topical v Systemic Agent Treatment for Papulopustular AcneA Cost-effectiveness Analysis

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.

Arch Dermatol. 1984;120(12):1571-1578. doi:10.1001/archderm.1984.01650480033013

• 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)