Photodynamic Therapy Cost-Effective for High-Grade CIN

PDT found to be more cost effective than conization for cervical intraepithelial neoplasia in Germany

FRIDAY, Sept. 2 (HealthDay News) -- In Germany, photodynamic therapy (PDT) using hexylaminolevulinate (HAL) has the potential to be a more cost-effective treatment for high-grade cervical intraepithelial neoplasia (CIN) than conization, and implementation of PDT may reduce perinatal morbidity and associated costs, according to a study published in the September issue of Lasers in Surgery and Medicine.

Philipp Soergel, M.D., from the Hannover Medical School in Germany, and colleagues compared the economical aspect of including associated pregnancy complications of conization procedures with that of PDT using HAL in the treatment of CIN. Models for both conization procedures and PDT using HAL were developed, and total costs for both treatment pathways, including necessary retreatments or alternative treatments, were assessed. The estimated impact of prematurity, conization-related cervical insufficiency, perinatal morbidity, and life-long disability were assessed. Perinatal morbidity-related total additional costs were calculated per conization.

The investigators found that the treatment cost for the conization procedure was €1,473. Assuming a 50 percent rate of re-PDT, a 70 percent response rate, and costs of €500 for the PDT intervention itself, the cost of PDT alone was €1,386. Conization procedures before 28 weeks, between 28 and less than 32 weeks, and between 32 and less than 37 weeks of gestation, resulted in 71, 144, and 545 infants born prematurely, respectively, leading to 18, 24, and 65 cases of severe, moderate, and mild life-long disability, respectively. For each conization, the additional amount attributed to maternofetal morbidity discounted by 3 percent for seven years was €573, adding up to a total cost of €2,046 per conization. Based on similar assumptions, the total costs per treatment with PDT were €1,558.

"For Germany, PDT has the potential to be a cost-effective treatment for high-grade CIN compared to conization procedure," the authors write.

Two of the study authors disclosed financial ties with Photocure ASA, which is involved in photodynamic therapy.

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