Evaluation of Cost-Effectiveness and Patient Satisfaction of Topical, Topical Plus Systemic, and Topical Plus Laser Treatment in Patients with Acne Vulgaris

Abstract

Acne vulgaris is a common skin problem in adolescents and young adults, reducing quality of life and causing psychological distress. Topical, systemic, and laser therapies are widely used, but comparative evidence in Southeast Asia is limited. Studies indicate that combination therapy (topical + systemic or topical + laser) is generally more effective than monotherapy. Laser plus topical therapy reduces inflammatory lesions more than topical therapy alone, though cost-effectiveness is rarely assessed. A meta-analysis (Yeung et al., 2021) supports the superiority of combination therapy, while NICE (2021) found topical + systemic more costeffective in the UK. This study evaluated cost-effectiveness and patient satisfaction of topical, topical + systemic, and topical + laser treatment in acne vulgaris. A prospective cohort study at Erha Clinic (April 2024–March 2025) involved 90 participants divided into three equal groups (n = 30). Quality of life, satisfaction, and cost-effectiveness were measured using CADI, VAS, and total costs at baseline, 2, 4, 8, and 12 weeks, analysed with IBM SPSS 22. Lesion reduction was greatest with topical + laser (21.17 → 0.10; USD 369.09), followed by topical + systemic (15.50 → 0.17; USD 298.71) and topical (15.17 → 0.40; USD 198.71). Topical + laser achieved the fastest IGA score reduction (CER USD 97.90). For CADI, topical therapy was most cost-effective (USD 3.52), followed by topical + systemic (USD 4.74) and topical + laser (USD 11.89). In satisfaction, topical was also most economical (USD 6.93). All therapies effectively reduced acne severity; topical + laser gave the best clinical results but at the highest cost, while topical alone was most cost-efficient.