To freeze or not to freeze: a cost-effectiveness analysis of wart treatment

M. R. Keogh-Brown, R. J. Fordham, K. S. Thomas, M. O. Bachmann, R. C. Holland, A. J. Avery, S. J. Armstrong, J. R. Chalmers, A. C. Howe, S. Rodgers, H. C. Williams, I. M. Harvey

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19 Citations (Scopus)


Background: Several general practitioner (GP)-prescribed and over-the-counter therapies for warts and verrucae are available. However, the cost-effectiveness of these treatments is unknown.

Objectives: To compare the cost-effectiveness of different treatments for cutaneous warts.

Methods: We designed a decision-analytic Markov simulation model based on systematic review evidence to estimate the cost-effectiveness of various treatments. The outcome measures studied are percentage of patients cured, cost of treatment and incremental cost-effectiveness ratio for each treatment, compared with no treatment, after 18 weeks.

Results: Duct tape was most cost-effective but published evidence of its effectiveness is sparse. Salicylic acid was the most cost-effective over-the-counter treatment commonly used. Cryotherapy administered by a GP was less cost-effective than GP-prescribed salicylic acid and less cost-effective than cryotherapy administered by a nurse.

Conclusions: Duct tape could be adopted as the primary treatment for cutaneous warts if its effectiveness is verified by further rigorous trials. Nurse-administered cryotherapy is likely to be more cost-effective than GP-administered cryotherapy.
Original languageEnglish
Pages (from-to)687–692
Number of pages6
JournalBritish Journal of Dermatology
Issue number4
Publication statusPublished - Apr 2007


  • cryotherapy
  • decision analysis
  • Markov model
  • salicylic acid

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