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The Cost Utility of Nonpregnancy Laboratory Monitoring for Persons on Isotretinoin Acne Therapy.

Publication ,  Journal Article
Borre, ED; Chen, SC; Nicholas, MW
Published in: JID Innov
May 2023

We sought to project the 1-year cost utility of nonpregnancy laboratory monitoring cessation among patients initiating isotretinoin. We conducted a model-based cost utility analysis comparing (i) current practice (CP) and (ii) cessation of nonpregnancy laboratory monitoring. Simulated 20-year-old persons initiating isotretinoin were maintained on therapy for 6 months, unless taken off because of laboratory abnormalities in CP. Model inputs included probabilities of cell-line abnormalities (0.12%/wk), early cessation of isotretinoin therapy after detection of an abnormal laboratory result (2.2%/wk, CP only), quality-adjusted life-years (0.84-0.93), and laboratory monitory costs ($5/wk). We collected adverse events, deaths, and quality-adjusted life-years and costs (2020 USD) from a health care payer perspective. Over 1 year, and for 200,000 people on isotretinoin in the United States, the CP strategy resulted in 184,730 quality-adjusted life-years (0.9236 per person), and nonpregnancy laboratory monitoring resulted in 184,770 quality-adjusted life-years (0.9238 per person). The CP and nonpregnancy laboratory monitoring strategies resulted in 0.08 and 0.09 isotretinoin-related deaths, respectively. Nonpregnancy laboratory monitoring was the dominating strategy, realizing $24 million savings per year. No variation of a single parameter across its plausible range changed our cost utility findings. Cessation of laboratory monitoring could realize savings of $24 million per year for the US health care system and improve patient outcomes, with negligible effects on adverse events.

Duke Scholars

Published In

JID Innov

DOI

EISSN

2667-0267

Publication Date

May 2023

Volume

3

Issue

3

Start / End Page

100186

Location

Netherlands
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Borre, E. D., Chen, S. C., & Nicholas, M. W. (2023). The Cost Utility of Nonpregnancy Laboratory Monitoring for Persons on Isotretinoin Acne Therapy. JID Innov, 3(3), 100186. https://doi.org/10.1016/j.xjidi.2023.100186
Borre, Ethan D., Suephy C. Chen, and Matilda W. Nicholas. “The Cost Utility of Nonpregnancy Laboratory Monitoring for Persons on Isotretinoin Acne Therapy.JID Innov 3, no. 3 (May 2023): 100186. https://doi.org/10.1016/j.xjidi.2023.100186.
Borre ED, Chen SC, Nicholas MW. The Cost Utility of Nonpregnancy Laboratory Monitoring for Persons on Isotretinoin Acne Therapy. JID Innov. 2023 May;3(3):100186.
Borre, Ethan D., et al. “The Cost Utility of Nonpregnancy Laboratory Monitoring for Persons on Isotretinoin Acne Therapy.JID Innov, vol. 3, no. 3, May 2023, p. 100186. Pubmed, doi:10.1016/j.xjidi.2023.100186.
Borre ED, Chen SC, Nicholas MW. The Cost Utility of Nonpregnancy Laboratory Monitoring for Persons on Isotretinoin Acne Therapy. JID Innov. 2023 May;3(3):100186.

Published In

JID Innov

DOI

EISSN

2667-0267

Publication Date

May 2023

Volume

3

Issue

3

Start / End Page

100186

Location

Netherlands