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Direct medical costs for surgical and medical treatment of condylomata acuminata.

OBJECTIVE
To determine which treatment modalities for condylomata acuminata are associated with the lowest direct medical costs.


DESIGN
Cost-effectiveness analysis.


SETTING
Ambulatory private practice, primary or specialty care.


PATIENTS OR OTHER PARTICIPANTS
Adults with no presenting complaints other than condylomata acuminata.


INTERVENTIONS
Construction of a cost-effectiveness model. From a literature review, extraction of commonly accepted guidelines regarding duration and frequency as well as reports of efficacies of typical treatment regimens; from Medicare physician fee schedules, costs of physician visits and physician-administered treatments; from published data, average wholesale prices of medications.


MAIN OUTCOME MEASURE
Estimated direct medical costs per complete clearance associated with different treatment options for condylomata acuminata.


RESULTS
Mean direct medical costs per complete clearance are lowest for surgical excision ($285). Other low-cost modalities are loop electrosurgical excision procedure ($316), electrodesiccation ($347), carbon dioxide laser ($416), podofilox ($424), and pulsed-dye laser ($479). Higher-cost modalities are cryotherapy ($951), trichloroacetic acid ($986), imiquimod ($1255), podophyllum resin ($1632), and interferon alfa-2b ($6665).


CONCLUSION
Surgical modalities, including excision, electrodesiccation, loop electrosurgical excision procedure, and laser, as well as podofilox are low-cost options for the treatment of condylomata acuminata.