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- Title
A COST-EFFECTIVENESS ANALYSIS OF rhDNase IN CHILDREN WITH CYSTIC FIBROSIS.
- Authors
Richard Grieve; Simon Thompson; Charles Normand; Ranjan Suri; Andrew Bush; Colin Wallis
- Abstract
Objectives: This study compared the relative cost-effectiveness of daily recombinant human deoxyribonuclease (rhDNase), with alternate day rhDNase and hypertonic saline (HS) for treating children with cystic fibrosis (CF). Methods: A randomized controlled trial with a crossover design allocated 40 CF children consecutively to 12 weeks of daily rhDNase, alternate day rhDNase, or HS. The primary outcome measure was forced expiratory volume in 1 second (FEV1), a measure of lung function. All health resource use was prospectively documented for each patient and multiplied by unit costs to give a total health service cost for each 12-week treatment period. The nonparametric bootstrap method was used to present cost-effectiveness acceptability curves and net benefit statistics for each treatment comparison, for various hypothetical levels of the decision maker's ceiling ratio. Results: Compared with HS, there was a 14% improvement in FEV1 for daily rhDNase (95% CI, 5% to 23%), and a 12% improvement (95% CI, 2% to 22%) for alternate day rhDNase. For a ceiling ratio of £200 per 1% gain in FEV1, the mean net benefits of daily and alternate day rhDNase compared with HS were £1,158 (95% CI, -£621 to 2,842) and £1,188 (95% CI, -847 to 3,343), respectively; the mean net benefit of daily compared with alternate day rhDNase was *minus;£30 (95% CI, -£2,091 to 1,576). Conclusions: If decision makers are prepared to pay £200 for a 1% gain in FEV1 over a 12-week period, then on average either rhDNase strategy is cost-effective.
- Subjects
DEOXYRIBONUCLEASES; NUCLEASES; CYSTIC fibrosis treatment; GENETIC disorders; HEALTH
- Publication
International Journal of Technology Assessment in Health Care, 2003, Vol 19, Issue 1, p71
- ISSN
0266-4623
- Publication type
Article
- DOI
10.1017/S0266462303000072