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Cost-effectiveness of metered-dose inhalers for asthma exacerbations in the pediatric emergency department.
- Source :
-
Pediatrics [Pediatrics] 2011 May; Vol. 127 (5), pp. e1105-11. Date of Electronic Publication: 2011 Apr 04. - Publication Year :
- 2011
-
Abstract
- Objective: To compare the incremental cost and effects (averted admission) of using a metered-dose inhaler (MDI) against wet nebulization to deliver bronchodilators for the treatment of mild to moderately severe asthma in pediatric emergency departments (EDs).<br />Methods: We measured the incremental cost-effectiveness from the perspective of the hospital, by creating a model using outcome characteristics from a Cochrane systematic review comparing the efficacy of using MDIs versus nebulizers for the delivery of albuterol to children presenting to the ED with asthma. Cost data were obtained from hospitals and regional authorities. We determined the incremental cost-effectiveness ratio and performed probabilistic sensitivity analyses using Monte Carlo simulations.<br />Results: Using MDIs in the ED instead of wet nebulization may result in net savings of Can$154.95 per patient. Our model revealed that using MDIs in the ED is a dominant strategy, one that is more effective and less costly than wet nebulization. Probabilistic sensitivity analyses revealed that 98% of the 10 000 iterations resulted in a negative incremental cost-effectiveness ratio. Sensitivity analyses around the costs revealed that MDI would remain a dominant strategy (90% of 10 000 iterations) even if the net cost of delivering bronchodilators by MDI was Can$70 more expensive than that of nebulized bronchodilators.<br />Conclusions: Use of MDIs with spacers in place of wet nebulizers to deliver albuterol to treat children with mild-to-moderate asthma exacerbations in the ED could yield significant cost savings for hospitals and, by extension, to both the health care system and families of children with asthma.
- Subjects :
- Administration, Inhalation
Adolescent
Albuterol economics
Asthma diagnosis
British Columbia
Child
Child, Preschool
Cost-Benefit Analysis
Decision Support Techniques
Emergency Treatment economics
Emergency Treatment methods
Female
Humans
Male
Monte Carlo Method
Nebulizers and Vaporizers economics
Recurrence
Severity of Illness Index
Albuterol administration & dosage
Asthma drug therapy
Cost Savings
Emergency Service, Hospital
Metered Dose Inhalers economics
Subjects
Details
- Language :
- English
- ISSN :
- 1098-4275
- Volume :
- 127
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 21464192
- Full Text :
- https://doi.org/10.1542/peds.2010-2963