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.