Comparing therapy costs for physician treatment of warts

To compare the cost of several common modalities used to treat non-genital warts in immunocompetent patients, we identified studies published in English using standard search strategies and evaluated the literature for the following common non-genital wart therapies: cryotherapy with liquid nitrogen, carbon dioxide and pulsed-dye laser therapy, topical squaric acid, intralesional bleomycin, intralesional interferon alpha injections, and intralesional immunotherapy with Candida antigens. Standard treatment algorithms, compiled by dermatologists experienced in the treatment of patients with moderate wart burdens, were utilized for cost-comparison analyses. Based on the cost analysis model, the least expensive treatment option for non-genital warts were carbon dioxide laser therapy (157 dollars) and Candida antigen injections (190 dollars). The other treatment modalities examined ranged from 495 dollars (bleomycin) to 1227 dollars (interferon alpha). Although treatment with the carbon dioxide laser therapy is the least expensive, pain and post-procedure complications limit the use of this modality.