Cost‐effectiveness analysis of phenotypic‐guided versus guidelines‐guided bronchodilator therapy in viral bronchiolitis
Objectives Although recent evidence suggests that management of viral bronchiolitis requires something other than guidelines‐guided therapy, there is a lack of evidence supporting the economic benefits of phenotypic‐guided bronchodilator therapy for treating this disease. The aim of the present stud...
Gespeichert in:
Veröffentlicht in: | Pediatric pulmonology 2021-01, Vol.56 (1), p.187-195 |
---|---|
Hauptverfasser: | , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 195 |
---|---|
container_issue | 1 |
container_start_page | 187 |
container_title | Pediatric pulmonology |
container_volume | 56 |
creator | Rodriguez‐Martinez, Carlos E. Nino, Gustavo Castro‐Rodriguez, Jose A. Perez, Geovanny F. Sossa‐Briceño, Monica P. Buendia, Jefferson A. |
description | Objectives
Although recent evidence suggests that management of viral bronchiolitis requires something other than guidelines‐guided therapy, there is a lack of evidence supporting the economic benefits of phenotypic‐guided bronchodilator therapy for treating this disease. The aim of the present study was to compare the cost‐effectiveness of phenotypic‐guided versus guidelines‐guided bronchodilator therapy in infants with viral bronchiolitis.
Methods
A decision analysis model was developed to compare the cost‐effectiveness of phenotypic‐guided versus guidelines‐guided bronchodilator therapy in infants with viral bronchiolitis. Phenotypic‐guided bronchodilator therapy was defined as the administration of albuterol in infants exhibiting a profile of increased likelihood of response to bronchodilators. The effectiveness parameters and costs of the model were obtained from systematic reviews of the literature with meta‐analyses and electronic medical records. The main outcome was the avoidance of hospital admission after initial care in the emergency department.
Results
Compared to guidelines‐guided strategy, treating patients with viral bronchiolitis with the phenotypic‐guided bronchodilator therapy strategy was associated with lower total costs (US$250.99; 95% uncertainty interval [UI]: US$184.37 to $336.51 vs. US$263.46; 95% UI: US$189.81 to $349.19 average cost per patient) and a higher probability of avoidance of hospital admission (0.7902; 95% UI: 0.7315–0.8356 vs. 0.7638; 95% UI: 0.7062–0.8201), thus leading to dominance. Results were robust to deterministic and probabilistic sensitivity analyses.
Conclusions
Compared to guidelines‐guided strategy, treating infants with viral bronchiolitis using the phenotypic‐guided bronchodilator therapy strategy is a more cost‐effective strategy, because it involves a lower probability of hospital admission at lower total treatment costs. |
doi_str_mv | 10.1002/ppul.25114 |
format | Article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8850934</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2469851467</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4484-10f1c2c026f911352ecaced7854afb5a4968c2f7dfce9668d084eb20308bb6493</originalsourceid><addsrcrecordid>eNp9kc1u3CAYRVGVqpmk3eQBIkvZVfIUMGZgEykaNT_SSM2iWSOMPzJEjnHAnsiLSn2EPGOeJMxPp-mmK4Tu4fDBReiE4CnBmH7ruqGZ0pIQ9gFNCJYyx0zyAzQRs7LMueDFITqK8QHjlEnyCR0WRSII5RP0a-5j__r7BawF07sVtBBjplvdjNHFzNusW0Lr-7FzJmH3g6uhzlYQ4hCzza5x6cjfqAq-NUtfu0b3PmT9EoLuxsy12coF3exy5xvXu_gZfbS6ifBltx6ju8vvP-fX-eLH1c38YpEbxgTLCbbEUIMpt5KQoqRgtIF6JkqmbVXq9FphqJ3V1oDkXNRYMKgoLrCoKs5kcYzOt95uqB6hNtD2aRbVBfeow6i8durfpHVLde9XSogSy4IlwdlOEPzTALFXD34I6ZeiooxLURLGZ4n6uqVM8DEGsPsbCFbrqtS6KrWpKsGn72fao3-6SQDZAs-ugfE_KnV7e7fYSt8AzrCnDw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2469851467</pqid></control><display><type>article</type><title>Cost‐effectiveness analysis of phenotypic‐guided versus guidelines‐guided bronchodilator therapy in viral bronchiolitis</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Rodriguez‐Martinez, Carlos E. ; Nino, Gustavo ; Castro‐Rodriguez, Jose A. ; Perez, Geovanny F. ; Sossa‐Briceño, Monica P. ; Buendia, Jefferson A.</creator><creatorcontrib>Rodriguez‐Martinez, Carlos E. ; Nino, Gustavo ; Castro‐Rodriguez, Jose A. ; Perez, Geovanny F. ; Sossa‐Briceño, Monica P. ; Buendia, Jefferson A.</creatorcontrib><description>Objectives
Although recent evidence suggests that management of viral bronchiolitis requires something other than guidelines‐guided therapy, there is a lack of evidence supporting the economic benefits of phenotypic‐guided bronchodilator therapy for treating this disease. The aim of the present study was to compare the cost‐effectiveness of phenotypic‐guided versus guidelines‐guided bronchodilator therapy in infants with viral bronchiolitis.
Methods
A decision analysis model was developed to compare the cost‐effectiveness of phenotypic‐guided versus guidelines‐guided bronchodilator therapy in infants with viral bronchiolitis. Phenotypic‐guided bronchodilator therapy was defined as the administration of albuterol in infants exhibiting a profile of increased likelihood of response to bronchodilators. The effectiveness parameters and costs of the model were obtained from systematic reviews of the literature with meta‐analyses and electronic medical records. The main outcome was the avoidance of hospital admission after initial care in the emergency department.
Results
Compared to guidelines‐guided strategy, treating patients with viral bronchiolitis with the phenotypic‐guided bronchodilator therapy strategy was associated with lower total costs (US$250.99; 95% uncertainty interval [UI]: US$184.37 to $336.51 vs. US$263.46; 95% UI: US$189.81 to $349.19 average cost per patient) and a higher probability of avoidance of hospital admission (0.7902; 95% UI: 0.7315–0.8356 vs. 0.7638; 95% UI: 0.7062–0.8201), thus leading to dominance. Results were robust to deterministic and probabilistic sensitivity analyses.
Conclusions
Compared to guidelines‐guided strategy, treating infants with viral bronchiolitis using the phenotypic‐guided bronchodilator therapy strategy is a more cost‐effective strategy, because it involves a lower probability of hospital admission at lower total treatment costs.</description><identifier>ISSN: 8755-6863</identifier><identifier>EISSN: 1099-0496</identifier><identifier>DOI: 10.1002/ppul.25114</identifier><identifier>PMID: 33049126</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Administration, Inhalation ; Albuterol - therapeutic use ; bronchiolitis ; Bronchiolitis - therapy ; Bronchiolitis - virology ; Bronchiolitis, Viral - drug therapy ; Bronchitis ; Bronchodilator Agents - therapeutic use ; Bronchodilators ; Clinical practice guidelines ; Cost analysis ; Cost-Benefit Analysis ; cost‐effectiveness ; Electronic Health Records ; Emergency Service, Hospital ; Genotype & phenotype ; Health Care Costs ; Health economics ; Hospitalization ; Humans ; Infant ; phenotype ; Respiratory therapy</subject><ispartof>Pediatric pulmonology, 2021-01, Vol.56 (1), p.187-195</ispartof><rights>2020 Wiley Periodicals LLC</rights><rights>2020 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4484-10f1c2c026f911352ecaced7854afb5a4968c2f7dfce9668d084eb20308bb6493</citedby><cites>FETCH-LOGICAL-c4484-10f1c2c026f911352ecaced7854afb5a4968c2f7dfce9668d084eb20308bb6493</cites><orcidid>0000-0002-0708-4281 ; 0000-0003-2404-6612 ; 0000-0001-8621-6109 ; 0000-0003-2560-6693</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fppul.25114$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fppul.25114$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33049126$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rodriguez‐Martinez, Carlos E.</creatorcontrib><creatorcontrib>Nino, Gustavo</creatorcontrib><creatorcontrib>Castro‐Rodriguez, Jose A.</creatorcontrib><creatorcontrib>Perez, Geovanny F.</creatorcontrib><creatorcontrib>Sossa‐Briceño, Monica P.</creatorcontrib><creatorcontrib>Buendia, Jefferson A.</creatorcontrib><title>Cost‐effectiveness analysis of phenotypic‐guided versus guidelines‐guided bronchodilator therapy in viral bronchiolitis</title><title>Pediatric pulmonology</title><addtitle>Pediatr Pulmonol</addtitle><description>Objectives
Although recent evidence suggests that management of viral bronchiolitis requires something other than guidelines‐guided therapy, there is a lack of evidence supporting the economic benefits of phenotypic‐guided bronchodilator therapy for treating this disease. The aim of the present study was to compare the cost‐effectiveness of phenotypic‐guided versus guidelines‐guided bronchodilator therapy in infants with viral bronchiolitis.
Methods
A decision analysis model was developed to compare the cost‐effectiveness of phenotypic‐guided versus guidelines‐guided bronchodilator therapy in infants with viral bronchiolitis. Phenotypic‐guided bronchodilator therapy was defined as the administration of albuterol in infants exhibiting a profile of increased likelihood of response to bronchodilators. The effectiveness parameters and costs of the model were obtained from systematic reviews of the literature with meta‐analyses and electronic medical records. The main outcome was the avoidance of hospital admission after initial care in the emergency department.
Results
Compared to guidelines‐guided strategy, treating patients with viral bronchiolitis with the phenotypic‐guided bronchodilator therapy strategy was associated with lower total costs (US$250.99; 95% uncertainty interval [UI]: US$184.37 to $336.51 vs. US$263.46; 95% UI: US$189.81 to $349.19 average cost per patient) and a higher probability of avoidance of hospital admission (0.7902; 95% UI: 0.7315–0.8356 vs. 0.7638; 95% UI: 0.7062–0.8201), thus leading to dominance. Results were robust to deterministic and probabilistic sensitivity analyses.
Conclusions
Compared to guidelines‐guided strategy, treating infants with viral bronchiolitis using the phenotypic‐guided bronchodilator therapy strategy is a more cost‐effective strategy, because it involves a lower probability of hospital admission at lower total treatment costs.</description><subject>Administration, Inhalation</subject><subject>Albuterol - therapeutic use</subject><subject>bronchiolitis</subject><subject>Bronchiolitis - therapy</subject><subject>Bronchiolitis - virology</subject><subject>Bronchiolitis, Viral - drug therapy</subject><subject>Bronchitis</subject><subject>Bronchodilator Agents - therapeutic use</subject><subject>Bronchodilators</subject><subject>Clinical practice guidelines</subject><subject>Cost analysis</subject><subject>Cost-Benefit Analysis</subject><subject>cost‐effectiveness</subject><subject>Electronic Health Records</subject><subject>Emergency Service, Hospital</subject><subject>Genotype & phenotype</subject><subject>Health Care Costs</subject><subject>Health economics</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Infant</subject><subject>phenotype</subject><subject>Respiratory therapy</subject><issn>8755-6863</issn><issn>1099-0496</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u3CAYRVGVqpmk3eQBIkvZVfIUMGZgEykaNT_SSM2iWSOMPzJEjnHAnsiLSn2EPGOeJMxPp-mmK4Tu4fDBReiE4CnBmH7ruqGZ0pIQ9gFNCJYyx0zyAzQRs7LMueDFITqK8QHjlEnyCR0WRSII5RP0a-5j__r7BawF07sVtBBjplvdjNHFzNusW0Lr-7FzJmH3g6uhzlYQ4hCzza5x6cjfqAq-NUtfu0b3PmT9EoLuxsy12coF3exy5xvXu_gZfbS6ifBltx6ju8vvP-fX-eLH1c38YpEbxgTLCbbEUIMpt5KQoqRgtIF6JkqmbVXq9FphqJ3V1oDkXNRYMKgoLrCoKs5kcYzOt95uqB6hNtD2aRbVBfeow6i8durfpHVLde9XSogSy4IlwdlOEPzTALFXD34I6ZeiooxLURLGZ4n6uqVM8DEGsPsbCFbrqtS6KrWpKsGn72fao3-6SQDZAs-ugfE_KnV7e7fYSt8AzrCnDw</recordid><startdate>202101</startdate><enddate>202101</enddate><creator>Rodriguez‐Martinez, Carlos E.</creator><creator>Nino, Gustavo</creator><creator>Castro‐Rodriguez, Jose A.</creator><creator>Perez, Geovanny F.</creator><creator>Sossa‐Briceño, Monica P.</creator><creator>Buendia, Jefferson A.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0708-4281</orcidid><orcidid>https://orcid.org/0000-0003-2404-6612</orcidid><orcidid>https://orcid.org/0000-0001-8621-6109</orcidid><orcidid>https://orcid.org/0000-0003-2560-6693</orcidid></search><sort><creationdate>202101</creationdate><title>Cost‐effectiveness analysis of phenotypic‐guided versus guidelines‐guided bronchodilator therapy in viral bronchiolitis</title><author>Rodriguez‐Martinez, Carlos E. ; Nino, Gustavo ; Castro‐Rodriguez, Jose A. ; Perez, Geovanny F. ; Sossa‐Briceño, Monica P. ; Buendia, Jefferson A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4484-10f1c2c026f911352ecaced7854afb5a4968c2f7dfce9668d084eb20308bb6493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Administration, Inhalation</topic><topic>Albuterol - therapeutic use</topic><topic>bronchiolitis</topic><topic>Bronchiolitis - therapy</topic><topic>Bronchiolitis - virology</topic><topic>Bronchiolitis, Viral - drug therapy</topic><topic>Bronchitis</topic><topic>Bronchodilator Agents - therapeutic use</topic><topic>Bronchodilators</topic><topic>Clinical practice guidelines</topic><topic>Cost analysis</topic><topic>Cost-Benefit Analysis</topic><topic>cost‐effectiveness</topic><topic>Electronic Health Records</topic><topic>Emergency Service, Hospital</topic><topic>Genotype & phenotype</topic><topic>Health Care Costs</topic><topic>Health economics</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Infant</topic><topic>phenotype</topic><topic>Respiratory therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rodriguez‐Martinez, Carlos E.</creatorcontrib><creatorcontrib>Nino, Gustavo</creatorcontrib><creatorcontrib>Castro‐Rodriguez, Jose A.</creatorcontrib><creatorcontrib>Perez, Geovanny F.</creatorcontrib><creatorcontrib>Sossa‐Briceño, Monica P.</creatorcontrib><creatorcontrib>Buendia, Jefferson A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatric pulmonology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rodriguez‐Martinez, Carlos E.</au><au>Nino, Gustavo</au><au>Castro‐Rodriguez, Jose A.</au><au>Perez, Geovanny F.</au><au>Sossa‐Briceño, Monica P.</au><au>Buendia, Jefferson A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost‐effectiveness analysis of phenotypic‐guided versus guidelines‐guided bronchodilator therapy in viral bronchiolitis</atitle><jtitle>Pediatric pulmonology</jtitle><addtitle>Pediatr Pulmonol</addtitle><date>2021-01</date><risdate>2021</risdate><volume>56</volume><issue>1</issue><spage>187</spage><epage>195</epage><pages>187-195</pages><issn>8755-6863</issn><eissn>1099-0496</eissn><abstract>Objectives
Although recent evidence suggests that management of viral bronchiolitis requires something other than guidelines‐guided therapy, there is a lack of evidence supporting the economic benefits of phenotypic‐guided bronchodilator therapy for treating this disease. The aim of the present study was to compare the cost‐effectiveness of phenotypic‐guided versus guidelines‐guided bronchodilator therapy in infants with viral bronchiolitis.
Methods
A decision analysis model was developed to compare the cost‐effectiveness of phenotypic‐guided versus guidelines‐guided bronchodilator therapy in infants with viral bronchiolitis. Phenotypic‐guided bronchodilator therapy was defined as the administration of albuterol in infants exhibiting a profile of increased likelihood of response to bronchodilators. The effectiveness parameters and costs of the model were obtained from systematic reviews of the literature with meta‐analyses and electronic medical records. The main outcome was the avoidance of hospital admission after initial care in the emergency department.
Results
Compared to guidelines‐guided strategy, treating patients with viral bronchiolitis with the phenotypic‐guided bronchodilator therapy strategy was associated with lower total costs (US$250.99; 95% uncertainty interval [UI]: US$184.37 to $336.51 vs. US$263.46; 95% UI: US$189.81 to $349.19 average cost per patient) and a higher probability of avoidance of hospital admission (0.7902; 95% UI: 0.7315–0.8356 vs. 0.7638; 95% UI: 0.7062–0.8201), thus leading to dominance. Results were robust to deterministic and probabilistic sensitivity analyses.
Conclusions
Compared to guidelines‐guided strategy, treating infants with viral bronchiolitis using the phenotypic‐guided bronchodilator therapy strategy is a more cost‐effective strategy, because it involves a lower probability of hospital admission at lower total treatment costs.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33049126</pmid><doi>10.1002/ppul.25114</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-0708-4281</orcidid><orcidid>https://orcid.org/0000-0003-2404-6612</orcidid><orcidid>https://orcid.org/0000-0001-8621-6109</orcidid><orcidid>https://orcid.org/0000-0003-2560-6693</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 8755-6863 |
ispartof | Pediatric pulmonology, 2021-01, Vol.56 (1), p.187-195 |
issn | 8755-6863 1099-0496 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8850934 |
source | MEDLINE; Wiley Online Library All Journals |
subjects | Administration, Inhalation Albuterol - therapeutic use bronchiolitis Bronchiolitis - therapy Bronchiolitis - virology Bronchiolitis, Viral - drug therapy Bronchitis Bronchodilator Agents - therapeutic use Bronchodilators Clinical practice guidelines Cost analysis Cost-Benefit Analysis cost‐effectiveness Electronic Health Records Emergency Service, Hospital Genotype & phenotype Health Care Costs Health economics Hospitalization Humans Infant phenotype Respiratory therapy |
title | Cost‐effectiveness analysis of phenotypic‐guided versus guidelines‐guided bronchodilator therapy in viral bronchiolitis |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T16%3A19%3A25IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cost%E2%80%90effectiveness%20analysis%20of%20phenotypic%E2%80%90guided%20versus%20guidelines%E2%80%90guided%20bronchodilator%20therapy%20in%20viral%20bronchiolitis&rft.jtitle=Pediatric%20pulmonology&rft.au=Rodriguez%E2%80%90Martinez,%20Carlos%20E.&rft.date=2021-01&rft.volume=56&rft.issue=1&rft.spage=187&rft.epage=195&rft.pages=187-195&rft.issn=8755-6863&rft.eissn=1099-0496&rft_id=info:doi/10.1002/ppul.25114&rft_dat=%3Cproquest_pubme%3E2469851467%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2469851467&rft_id=info:pmid/33049126&rfr_iscdi=true |