The cost-effectiveness of hypertonic saline inhalations for infant bronchiolitis

Abstract

Background Pharmacological treatment for bronchiolitis is primarily supportive because bronchodilators, steroids, and antibiotics, show little benefit. Clinical studies have suggested that nebulized 3% hypertonic solution is useful for infants with bronchiolitis. This study aims to evaluate the cost-effectiveness of the HS inhalations in infant bronchiolitis in a tropical country. Methods Decision tree analysis was used to calculate the expected costs and QALYs. All cost and use of resources were collected directly from medical invoices of 193 patient hospitalized with diagnosis of bronchiolitis in tertiary centers, of Rionegro, Colombia. The utility values applied to QALYs calculations were collected from the literature. The economic analysis was carried out from a societal perspective. Results The model showed that nebulized 3% hypertonic solution, was associated with lower total cost than controls (US $200vs US $240 average cost per patient), and higher QALYs (0.92 vs 0.91 average per patient); showing dominance. A position of dominance negates the need to calculate an incremental cost-effectiveness ratio. Conclusion The nebulized 3% hypertonic solution was cost-effective in the inpatient treatment of infant bronchiolitis. Our study provides evidence that should be used by decision-makers to improve clinical practice guidelines and should be replicated to validate their results in other tropical countries.

Budget impact analysis of surfactant therapy for bronchiolitis in critically ill infants: the Colombian National Health System perspective

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“…This threshold (US$ 257) can be used as a reference for the control and regulation of prices in the country. Show evidence related to the economic impact this drug is essential to policy makers and physician [ 21 ] especially in developing countries where economic evaluation of drugs and medical devices in pediatric patients are increasing [ 17 , 22 – 25 ].…”

Critical care of severe bronchiolitis during shortage of ICU resources

“…Available data show that the ICU management of bronchiolitis, despite being expensive in absolute terms, consists of interventions that are likely to be cost-effective. 50 , 51 , 68 , 69 , 70 , 71 , 72 , 73 , 74 Data are summarised in Table 1 : this is not a formal cost-effectiveness analysis, since it is difficult to precisely assess some of these effects (e.g. the cost of inter-hospital transfer or the effects on families, which may vary according to several factors) and studies have different designs and outcomes.…”

Nebulisasi Salin Hipertonik pada Anak dengan Bronkiolitis

“…2,3 Mortalitas anak bronkiolitis berkisar antara 0,2-7%. 4 Sebagian besar panduan bronkiolitis merekomendasikan terapi suportif berupa suplementasi oksigen, hidrasi adekuat, dan pemberian ventilasi mekanik bila diperlukan. Terapi lain seperti steroid, salbutamol, dan salin hipertonik sering digunakan dalam terapi bronkiolitis tetapi efektivitasnya masih kontroversial.…”