Patients' willingness to accept adverse event and cost tradeoffs from oral nicotinamide for reduced risk of non-melanoma skin cancer

source extracted confidence: high 2026-04-09
#adult #male #humans #aged #female

Patients' willingness to accept adverse event and cost tradeoffs from oral nicotinamide for reduced risk of non-melanoma skin cancer

Boeri et al., 2023 | J Dermatolog Treat | Rct

Citation

Boeri Marco, Skelsey Maral K, ... Okun Martin M. Patients' willingness to accept adverse event and cost tradeoffs from oral nicotinamide for reduced risk of non-melanoma skin cancer. J Dermatolog Treat. 2023-Dec;34(1):2247105. doi:10.1080/09546634.2023.2247105

Abstract

BACKGROUND: Non-immunosuppressed patients with a history of multiple non-melanoma skin cancers (NMSCs) taking oral nicotinamide supplementation experienced a 23% decrease in annual NMSC risk in a randomized clinical trial. Patient preferences for risks and costs associated with nicotinamide are unknown. OBJECTIVES: To understand how patients prioritize NMSC reduction, infection risk, and cost. METHODS: A sample of adults with history of ≥2 NMSC within the past five years undergoing Mohs procedure completed a discrete-choice experiment comprising two hypothetical treatments-characterized by varying reductions in NMSC incidence, increased severe infection risk, and cost-and no treatment. The data were analyzed with random-parameters logit models. RESULTS: A total of 203 subjects (mean age 71.5 years, 65.5% males) participated. For a 23% annual reduction in NMSC incidence, a 26% [95% CI: 8%-45%] annual increase in severe infection risk and $8 [95% CI: $2-14] monthly cost was acceptable. Outcomes across analyzed subgroups (before vs. during COVID pandemic, site of interview, less vs. more prior NMSCs) were similar. CONCLUSIONS: Patients were unwilling to accept high severe infection risks to obtain the reduction in NMSC incidence observed in a nicotinamide trial, suggesting that routinely recommending nicotinamide may run counter to some patients' preferences.

Key Findings

A total of 203 subjects (mean age 71.5 years, 65.5% males) participated. For a 23% annual reduction in NMSC incidence, a 26% [95% CI: 8%-45%] annual increase in severe infection risk and $8 [95% CI: $2-14] monthly cost was acceptable. Outcomes across analyzed subgroups (before vs. during COVID pandemic, site of interview, less vs. more prior NMSCs) were similar.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population a history of multiple
Sample Size 203
Age Range mean age 71.5
Condition See abstract

MeSH Terms

  • Adult
  • Male
  • Humans
  • Aged
  • Female
  • COVID-19
  • Logistic Models
  • Niacinamide
  • Pandemics
  • Skin Neoplasms

Evidence Classification

  • Level: Rct
  • Publication Types: Randomized Controlled Trial, Journal Article
  • Vertical: niacin-skin

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09