Snakebite: An Exploratory Cost-Effectiveness Analysis of Adjunct Treatment Strategies
| Autor: | C. Soundara Raj, Tommaso C. Bulfone, Benjamin Herzel, Matthew R. Lewin, Stephen P. Samuel, James G. Kahn |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Palliative care Cost-Benefit Analysis 030231 tropical medicine Psychological intervention MEDLINE Snake Bites India Economic Medical and Health Sciences Cohort Studies 03 medical and health sciences 0302 clinical medicine Models Tropical Medicine Virology Intervention (counseling) medicine Humans 030212 general & internal medicine Intensive care medicine health care economics and organizations Cost–benefit analysis Antivenins business.industry Palliative Care Articles Cost-effectiveness analysis Adjunct Quality-adjusted life year Models Economic Infectious Diseases Parasitology Quality-Adjusted Life Years business |
| Zdroj: | The American journal of tropical medicine and hygiene, vol 99, iss 2 The American Journal of Tropical Medicine and Hygiene |
| ISSN: | 1476-1645 0002-9637 |
| DOI: | 10.4269/ajtmh.17-0922 |
| Popis: | The cost-effectiveness of the standard of care for snakebite treatment, antivenom, and supportive care has been established in various settings. In this study, based on data from South Indian private health-care providers, we address an additional question: “For what cost and effectiveness values would adding adjunct-based treatment strategies to the standard of care for venomous snakebites be cost-effective?” We modeled the cost and performance of potential interventions (e.g., pharmacologic or preventive) used adjunctively with antivenom and supportive care for the treatment of snakebite. Because these potential interventions are theoretical, we used a threshold cost-effectiveness approach to explore this forward-looking concept. We examined economic parameters at which these interventions could be cost-effective or even cost saving. A threshold analysis was used to examine the addition of new interventions to the standard of care. Incremental cost-effectiveness ratios were used to compare treatment strategies. One-way, scenario, and probabilistic sensitivity analyses were conducted to analyze parameter uncertainty and define cost and effectiveness thresholds. Our results suggest that even a 3% reduction in severe cases due to an adjunct strategy is likely to reduce the cost of overall treatment and have the greatest impact on cost-effectiveness. In this model, for example, an investment of $10 of intervention that reduces the incidence of severe cases by 3%, even without changing antivenom usage patterns, creates cost savings of $75 per individual. These findings illustrate the striking degree to which an adjunct intervention could improve patient outcomes and be cost-effective or even cost saving. |
| Databáze: | OpenAIRE |
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