Model Predicts Cost-Effectiveness for Anal Lesion Treatment
MONDAY, Oct. 16, 2017 -- Cost-effective management of precancerous anal intraepithelial lesions in HIV-positive men who have sex with men (MSM) varies by age, according to a study published online Sept. 26 in Cancer.
Ashish A. Deshmukh, Ph.D., M.P.H., from the University of Florida in Gainesville, and colleagues constructed a decision analytic model for the natural history of anal carcinoma and high-grade squamous intraepithelial lesion (HSIL) management strategies for HIV-positive MSM aged ≥27 years.
The researchers found that active monitoring was the most effective approach in patients ≤29 years, with HSIL treatment plus adjuvant quadrivalent human papillomavirus (qHPV) vaccination becoming most effective in older patients. Doing nothing was cost-effective until 38 years of age; HSIL treatment plus adjuvant qHPV vaccination was cost-effective after the age of 38 years. The incremental cost-effectiveness ratio decreased as the age at HSIL management increased. The rate of HSIL regression or progression and the cost of high-resolution anoscopy and biopsy affected outcomes.
"The management of HSIL in HIV-positive MSM who are 38 years old or older with treatment plus adjuvant qHPV vaccination is likely to be cost-effective," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
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Posted: October 2017