Comparison of Cost and Effectiveness between Isotretinoin versus Minocycline in the Treatment of Patients with Acne

Yoon, Yang Hyun; Ro, Byung In; Seo, Seong Jun; Kim, Myeung Nam; Hong, Chang Kwun

Abstract

BACKGROUND
Pharmacoeconomic analysis is increasingly becoming an integral component of the overall profile of new drugs. Since its introduction in 1981, isotretinoin (13-cis-retinoic acid) has revolutionized the treatment of severe cystic acne by dramatically improving clinical outcomes. Isotretinoin has also been used to treat less-than-severe forms of acne, particularly patients who failed in conventional therapy. PBJECTIVE: This study was undertaken to evaluate the cost-effectiveness of isotretinoin and minocycline for acne treatment. METHOD: We analyzed cost of drug, medical management of the disease and any adverse reactions, average total cost and cure rate (%), cumulative reduction rates (%) of grade, recurrence rate (%), total cost to final cumulative reduction rates (%) of grade and relative cost effectiveness ratio for each drug on the basis of total cost per disease-free period, RESULTS: 1. Total costs of isotretinoin and minocycline group were 795, 354.5+/-87, 382.6won and 432, 271.5+/-3, 892.1won, respectively (p<0.05). 2. Adverse rates of isotretinoin and minocycline group were 88.2% and 25.8%, respectively (p<0.05). 3. Disease free period of isotretinoin and minocycline group were 7.12+/-.51 months and 3.15+/-.62 months, respectively (p<0.05). 4. Rates of cure of isotretinoin and minocycline group were 29/34 (85.3%) and 20/31 (64.5%), respectively (p<0.05). 5. Rates of relapse of isotretinoin and minocycline group were 7/29 (24.1%) and 10/20, respectively (50.0%) (p<0.05). 6. The final cumulative reduction rates of grade of isotretinoin and minocycline group were 96.3+/-4.5% and 65.6+/-2, 6%, respectively (p<0.05). 7. Total costs to of final cumulative reduction rate (%) of grade of treatment between isotretinoin and minocycline group were 5, 331.2+/-24.5won and 5, 986.2+/-02.1won, respectively (p>0.05). 8. Total costs to disease-free period between isotretinoin and minocycline group were 82, 342.7+/-41.2won and 135, 782.3+/-32.3won, respectively (p<0.05). 9. Cost effectiveness ratio of isotretinoin on total costs to disease-free months was 0.65. CONCLUSION: This study has observed better cost-effectiveness of isotretinoin in acne patients in terms of disease-free periods, possibility of cure, rates of relapse, total costs to disease-free period in spite of its higher cost than minocycline.