The cost-effectiveness of hypertonic saline inhalations for infant bronchiolitis
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(2020) 20:1001
RESEARCH ARTICLE
Open Access
The cost-effectiveness of hypertonic saline inhalations for infant bronchiolitis Jefferson Antonio Buendía1* and Ranniery Acuña-Cordero2
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. Keywords: Bronchiolitis , Cost- effectiveness , Nebulization
Background Bronchiolitis is the primary reason for the hospitalization of infants in developed and developing countries [1]. Their mortality ranges from 0.2 to 7% [1, 2]. Morbidity and mortality mostly occur in children younger than 6 months with underlying pulmonary or cardiac disease, and those an immune deficiency [2]. In Colombia, the most common etiologic agent is the respiratory syncytial virus (RSV) [3] . In 2019, 260,873 years of life (IC 95% 208,180–347,023) were lost due to (RSV) - bronchiolitis in Colombian children under 2 * Correspondence: [email protected] 1 Grupo de Investigación en Farmacología y Toxicología (INFARTO). Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad de Antioquia, Carrera 51D #62-29, Medellín, Colombia Full list of author information is available at the end of the article
years. The estimated rate was 20 DALYs / 1000 personyear (95% CI 16–27) [4]. Bronchiolitis in children under age two years, generates more years of life lost, in Colombia, than cervical cancer between 45 and 59 years (1.6 DALYs per 1000 inhabitants), epilepsy between 30 and 44 years (1 DALYs per 1000 inhabitants) and leukemia in children between 5 and 14 years (1 DALYs per 1000 inhabitants) [4]. This due, partially, that in our country, almost 60% of patients with bronchiolitis have severe respiratory distress [3]. Th
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