Modeling the Anticipated Organizational Impact on Health Service Provision of the Introduction of Tirbanibulin for the Topical Treatment of Actinic Keratosis in France: EPIKA Study
Author(s)
Pierre Levy, PhD1, Brigitte Dreno, MD2, Grégory Caillet, MD3, Julie PAOLANTONACCI, Phd4, Jean-Michel JOUBERT, MD5, Jean-Michel AMICI, MD6.
1université Paris-Dauphine, Boulogne-Billancourt, France, 2University of Nantes, Nantes, France, 3Almirall SAS, Issy les Moulineaux, France, 4IQVIA, Courbevoie, France, 5Almirall SAS, Issy les moulineaux, France, 6Bordeaux University Hospital, Bordeaux, France.
1université Paris-Dauphine, Boulogne-Billancourt, France, 2University of Nantes, Nantes, France, 3Almirall SAS, Issy les Moulineaux, France, 4IQVIA, Courbevoie, France, 5Almirall SAS, Issy les moulineaux, France, 6Bordeaux University Hospital, Bordeaux, France.
OBJECTIVES: Assessment of the organisational impact (OI) of introduction of new healthcare interventions is now a recognised component of health technology assessments, and is required by health authorities in certain countries, including France. This modelling study aimed to assess the potential OI of introduction of tirbanibulin for the topical treatment of actinic keratosis on the French health system.
METHODS: This modelling study was performed within the framework proposed by the French Health Authorities and assessed impact on three domains (the care process, capacities and skills required, and impact on society), each divided into several sub-criteria. The modelling study incorporated data on the number of patients treated for AK by dermatologists in France, waiting time for appointments with dermatologists or General Practitioners (GPs), prescribing patterns for other simple-to-use topical treatments for acne, and historical experience with the now withdrawn ingenol mebutate. The study hypotheses were validated by a committee of expert dermatologists.
RESULTS: The principal domain expected to be impacted by the introduction of tirbanibulin is the care process. A transfer of competence for treating AK away from the dermatologist to the GP is anticipated, with 50.7% of AK patients eligible for a first-line treatment being treated by the GP compared to 15.3% currently, and 16,295 dermatologist consultations a year being avoided. Secondary to this, the mean delay to treatment initiation would be reduced from 55 days to 27 days (mean waiting time for consultation in France: 6 days for GPs and 61 days for dermatologists). The dermatologist consultations saved could be used for treatment of more severe AK with an expected increase in the number of cryotherapy and photodynamic therapy interventions of 53.8%.
CONCLUSIONS: Introduction of a convenient and safe topical treatment for AK would be expected to transfer care from the specialist to the primary care sector and thus facilitate access to treatment.
METHODS: This modelling study was performed within the framework proposed by the French Health Authorities and assessed impact on three domains (the care process, capacities and skills required, and impact on society), each divided into several sub-criteria. The modelling study incorporated data on the number of patients treated for AK by dermatologists in France, waiting time for appointments with dermatologists or General Practitioners (GPs), prescribing patterns for other simple-to-use topical treatments for acne, and historical experience with the now withdrawn ingenol mebutate. The study hypotheses were validated by a committee of expert dermatologists.
RESULTS: The principal domain expected to be impacted by the introduction of tirbanibulin is the care process. A transfer of competence for treating AK away from the dermatologist to the GP is anticipated, with 50.7% of AK patients eligible for a first-line treatment being treated by the GP compared to 15.3% currently, and 16,295 dermatologist consultations a year being avoided. Secondary to this, the mean delay to treatment initiation would be reduced from 55 days to 27 days (mean waiting time for consultation in France: 6 days for GPs and 61 days for dermatologists). The dermatologist consultations saved could be used for treatment of more severe AK with an expected increase in the number of cryotherapy and photodynamic therapy interventions of 53.8%.
CONCLUSIONS: Introduction of a convenient and safe topical treatment for AK would be expected to transfer care from the specialist to the primary care sector and thus facilitate access to treatment.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD75
Topic
Epidemiology & Public Health, Health Service Delivery & Process of Care, Real World Data & Information Systems
Disease
Sensory System Disorders (Ear, Eye, Dental, Skin)