Cost effectiveness of nasal budesonide versus surgical treatment for nasal polyps.

Abstract

OBJECTIVE:

To conduct a cost-effectiveness study of nasal budesonide versus surgical treatment in the management of nasal polyps.

DESIGN AND METHODS:

A decision-tree model reflecting two different treatment strategies for nasal polyps in Sweden was developed. The first strategy was initial polypectomy, performed under three different sets of circumstances: inpatient functional endoscopic surgery, outpatient evulsion with sedation, or outpatient evulsion with local anaesthesia; all treatments were followed by intranasal treatment with budesonide (Rhinocort) 128 microg twice daily. The second strategy was initial intranasal treatment with budesonide 128 microg twice daily.

PERSPECTIVE:

Healthcare provider perspective.

OUTCOME MEASURES AND RESULTS:

After 1 month, treatment with nasal budesonide was classified as a success (82.5%) or a failure (17.5%) based on clinical study data. In cases of success, the treatment was continued, and in cases of failure, polypectomy was undertaken, followed by budesonide 128 microg twice daily. Treatments were evaluated after 4 months using prices from the Central Hospital in Skövde, Sweden. The expected reduction in cost from using initial nasal budesonide treatment compared with the different alternatives of polypectomy were 9760 Swedish kronors (SEK) for inpatient functional endoscopic surgery, SEK2747 for outpatient evulsion with sedation, and SEK672 for outpatient evulsion with anaesthesia (1998 values). Nasal budesonide 128 microg twice daily treatment for nasal polyps revealed a potential reduction in costs of 53% compared with the primary surgery approach.

CONCLUSION:

Initial treatment of nasal polyps with nasal budesonide provides lower costs than treatment with initial polypectomy with maintained effectiveness.

• Authors: Fredrik Berggren, Leif Johansson
• Journal: PharmacoEconomics (Pharmacoeconomics) Vol. 21 Issue 5 Pg. 351-6 ( 2003) ISSN: 1170-7690 [Print] New Zealand
• PMID: 12627988 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents
• Budesonide

Topics

• Administration, Intranasal
• Anti-Inflammatory Agents (administration & dosage, economics, therapeutic use)
• Budesonide (administration & dosage, economics, therapeutic use)
• Clinical Trials as Topic
• Cost-Benefit Analysis
• Decision Trees
• Health Care Costs
• Humans
• Models, Economic
• Nasal Polyps (drug therapy, economics, surgery, therapy)
• Treatment Outcome