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The inflation-adjusted total cost of all topical immunomodulators was $232 million in 2008 and $252 million in 2010, researchers report in the Journal of the American Academy of Dermatology. Overall, the average total cost for a 30-day supply of medicine was $56.20 in 2008 and $51.90 in 2010. Researchers also analyzed prescriptions from doctors in specialty fields including dermatology, family medicine, internal medicine, psychiatry and neurology. Regardless of medication potency, prescriptions generally cost more when patients saw dermatologists than when they received care from other physicians, the study found. For patients, out of pocket cost for a 30-day prescription from a dermatologist was $13 to $14 higher than a prescription from a physician in family or internal medicine and $23 more than one from a specialist in psychiatry or neurology. In comparison to doctors in family or internal medicine, dermatologists prescribe drugs with a yearly cost of $30 million to $32 million more, and $25 million to $27 million more for prescriptions of similar potency, the authors calculate. This suggests that there's a potential to save up to about 11 percent on total costs using prescriptions from family and internal medicine doctors, they conclude. One limitation of the study is that it only includes adults 65 and older, which may mean the findings could be different for topical treatments more commonly prescribed for children, the authors note. The data also didn't specify that "specialists" were dermatologists, even though that is usually the type of provider who will treat patients with skin problems. Another challenge in cost comparisons for topical treatments is that people may use different amounts over different surface areas on the body. This means that unlike pills, which can easily be calculated into a daily cost, the amount patients use out of a single tube varies, contributing to differences in cost from one person to the next.

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