To freeze or not to freeze: a cost-effectiveness analysis of wart treatment

Br J Dermatol. 2007 Apr;156(4):687-92. doi: 10.1111/j.1365-2133.2007.07768.x. Epub 2007 Feb 27.


Background: Several general practitioner (GP)-prescribed and over-the-counter therapies for warts and verrucae are available. However, the cost-effectiveness of these treatments is unknown.

Objectives: To compare the cost-effectiveness of different treatments for cutaneous warts.

Methods: We designed a decision-analytic Markov simulation model based on systematic review evidence to estimate the cost-effectiveness of various treatments. The outcome measures studied are percentage of patients cured, cost of treatment and incremental cost-effectiveness ratio for each treatment, compared with no treatment, after 18 weeks.

Results: Duct tape was most cost-effective but published evidence of its effectiveness is sparse. Salicylic acid was the most cost-effective over-the-counter treatment commonly used. Cryotherapy administered by a GP was less cost-effective than GP-prescribed salicylic acid and less cost-effective than cryotherapy administered by a nurse.

Conclusions: Duct tape could be adopted as the primary treatment for cutaneous warts if its effectiveness is verified by further rigorous trials. Nurse-administered cryotherapy is likely to be more cost-effective than GP-administered cryotherapy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Anti-Infective Agents / therapeutic use*
  • Cost-Benefit Analysis
  • Cryotherapy / economics*
  • Dermatologic Agents / economics*
  • Dermatologic Agents / therapeutic use*
  • Humans
  • Salicylic Acid / economics*
  • Salicylic Acid / therapeutic use
  • Treatment Outcome
  • Warts / therapy*


  • Anti-Infective Agents
  • Dermatologic Agents
  • Salicylic Acid