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Dermatology Online Journal

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Cost-effectiveness analysis of using dermatologists versus pediatricians to treat mild to moderate acne


Objective: To assess the cost-effectiveness from thepayer perspective of using dermatologists versuspediatricians to treat acne in adolescents ages 10-18. Methods: A Markov model was constructed toexplore outcomes over a 2-year period from the USprivate payer perspective. Patients ages 10-18 withacne entered the model under the “dermatologist”and “pediatrician” conditions. In each 3-month cycle,each modeled patient received topical retinoids,benzoyl peroxide (BP), antibiotics, or no treatment,and could progress to an acne-free state or remainin an acne state. Results: The average patient spent42.3% of the time in acne-free states under thedermatologist condition and 28.0% of the time inacne-free states under the pediatrician condition.The cohort of 1000 patients experienced 1900 totalquality-adjusted life years (QALYs) at a cost of $2.33million in the dermatologist condition and 1883 totalQALYs at a cost of $1.62 million in the pediatriciancondition, yielding an ICER of $40,000/QALY. Mostsensitivity analyses confirmed the base case results.Conclusion: Dermatologist treatment appears costeffectiverelated to producing additional QALYs at acost of less than $100,000 per QALY gained. Healthplans should consider creating incentives to directenrollees to dermatologists for acne treatment.

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