Economic Evaluation of Using Daily Prednisolone versus Placebo at the Time of an Upper Respiratory Tract Infection for the Management of Children with Steroid-Sensitive Nephrotic Syndrome: A Model-Based Analysis.
Journal
PharmacoEconomics - open
ISSN: 2509-4254
Titre abrégé: Pharmacoecon Open
Pays: Switzerland
ID NLM: 101700780
Informations de publication
Date de publication:
Jul 2022
Jul 2022
Historique:
accepted:
28
03
2022
pubmed:
23
6
2022
medline:
23
6
2022
entrez:
22
6
2022
Statut:
ppublish
Résumé
Childhood steroid-sensitive nephrotic syndrome is a frequently relapsing disease with significant short- and long-term complications, leading to high healthcare costs and reduced quality of life for patients. The majority of relapses are triggered by upper respiratory tract infections (URTIs) and evidence shows that daily low-dose prednisolone at the time of infection may reduce the risk of relapse. The aim of this study was to assess the cost effectiveness of a 6-day course of low-dose prednisolone at the start of a URTI when compared with placebo. A state-transition Markov model was developed to conduct a cost-utility analysis with the outcome measured in quality-adjusted life-years (QALYs). Resource use and outcome data were derived from the PREDNOS2 trial. The analysis was performed from a UK National Health Service perspective and the results were extrapolated to adulthood. Model parameter and structural uncertainty were assessed using sensitivity analyses. The base-case results showed that administering low-dose prednisolone at the time of a URTI generated more QALYs and a lower mean cost at 1 year compared with placebo. In the long-term, low-dose prednisolone was associated with a cost saving (£176) and increased effectiveness (0.01 QALYs) compared with placebo and thus remained the dominant treatment option. These findings were robust to all sensitivity analyses. A 6-day course of low-dose prednisolone at the time of a URTI in children with steroid-sensitive nephrotic syndrome has the potential to reduce healthcare costs and improve quality of life compared with placebo.
Sections du résumé
BACKGROUND
BACKGROUND
Childhood steroid-sensitive nephrotic syndrome is a frequently relapsing disease with significant short- and long-term complications, leading to high healthcare costs and reduced quality of life for patients. The majority of relapses are triggered by upper respiratory tract infections (URTIs) and evidence shows that daily low-dose prednisolone at the time of infection may reduce the risk of relapse.
OBJECTIVE
OBJECTIVE
The aim of this study was to assess the cost effectiveness of a 6-day course of low-dose prednisolone at the start of a URTI when compared with placebo.
METHODS
METHODS
A state-transition Markov model was developed to conduct a cost-utility analysis with the outcome measured in quality-adjusted life-years (QALYs). Resource use and outcome data were derived from the PREDNOS2 trial. The analysis was performed from a UK National Health Service perspective and the results were extrapolated to adulthood. Model parameter and structural uncertainty were assessed using sensitivity analyses.
RESULTS
RESULTS
The base-case results showed that administering low-dose prednisolone at the time of a URTI generated more QALYs and a lower mean cost at 1 year compared with placebo. In the long-term, low-dose prednisolone was associated with a cost saving (£176) and increased effectiveness (0.01 QALYs) compared with placebo and thus remained the dominant treatment option. These findings were robust to all sensitivity analyses.
CONCLUSION
CONCLUSIONS
A 6-day course of low-dose prednisolone at the time of a URTI in children with steroid-sensitive nephrotic syndrome has the potential to reduce healthcare costs and improve quality of life compared with placebo.
Identifiants
pubmed: 35733076
doi: 10.1007/s41669-022-00334-6
pii: 10.1007/s41669-022-00334-6
pmc: PMC9283622
doi:
Types de publication
Journal Article
Langues
eng
Pagination
605-617Investigateurs
Nicholas Webb
(N)
Martin Christian
(M)
Natalie Ives
(N)
Emma Frew
(E)
Elizabeth Brettell
(E)
Emma Barsoum
(E)
Helen Bodenham-Chilton
(H)
Adam Khan
(A)
Noreen Akhtar
(N)
Charmaine Hunt
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Carla Galinha
(C)
Dominique Smith
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Neil Winkles
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Natalie Ives
(N)
Rebecca Woolley
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Samir Mehta
(S)
Catherine Moakes
(C)
Emma Frew
(E)
Nafsika Afentou
(N)
Wendy Cook
(W)
Sandra Cope
(S)
Megan Thomas
(M)
Nigel Coad
(N)
Sandra Cope
(S)
Darren Green
(D)
Kate Hillman
(K)
Zala Ibrahim
(Z)
Ly-Mee Yu
(LM)
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Informations de copyright
© 2022. The Author(s).
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