Economic evaluation of botulinum toxin versus thoracic sympathectomy for palmar hyperhidrosis: data from a real-world scenario
| Autor: | Beatriz Isla-Tejera, Teresa Brieva, María Antonia Alvarez Alvarez, Ángel Salvatierra, J.C. Moreno-Giménez, Manuel Cárdenas, José-Ramón del Prado-Llergo, Juan Ruano, Carlos Baamonde |
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| Rok vydání: | 2013 |
| Předmět: |
Pediatrics
medicine.medical_specialty business.industry Hyperhidrosis medicine.medical_treatment Endoscopic thoracic sympathectomy Absolute risk reduction Dermatology Odds ratio Tertiary referral hospital Botulinum toxin Surgery Sympathectomy Incremental cost-effectiveness analysis medicine Observational study medicine.symptom business health care economics and organizations Palmar hyperhidrosis medicine.drug Original Research |
| Zdroj: | Dermatology and Therapy |
| ISSN: | 2193-8210 |
| Popis: | Introduction Local botulinum toxin injections and endoscopic thoracic sympathectomy (ETS) have shown clinical effectiveness for the treatment of palmar hyperhidrosis in several studies. Although both strategies cause considerable costs for health-care systems, at the moment there are no studies examining directly their cost-effectiveness performance. The aim of the study was to assess the incremental cost-effectiveness of botulinum toxin when compared with ETS for palmar hyperhidrosis. Materials and Methods Costs, effectiveness, and incremental cost-effectiveness ratio (ICER) were calculated. Costs were assessed from a Spanish National Health System perspective in a historical cohort of patients with palmar hyperhidrosis attending a tertiary referral hospital. Effectiveness was evaluated by using the Hyperhidrosis Disease Severity Scale (HDSS). A responder was defined as a patient who reported at least a two-grade improvement on the HDSS scale with respect to the baseline value. The horizon of time was 1 year. Results Effectiveness was greater for ETS (n = 128) when compared with botulinum toxin (n = 100) for the treatment of palmar hyperhidrosis (92% vs. 68%; odds ratio (OR) = 6.22 [2.80, 13.80]; absolute risk ratio (ARR) = −0.24 [−0.45, −0.14]; number-needed-to-treat (NNT) = −4 [−2, −11]). Botulinum toxin had an ICER of 125 € when compared with ETS during the first year of treatment. Conclusions In this retrospective real-world observational sample of patients with palmar hyperhidrosis, treatment with ETS appears to be more effective and less costly when compared with botulinum toxin during the first year of treatment. Analyses such as this give decision makers the tools to choose a better treatment option which is both highly effective and yet has a low cost. |
| Databáze: | OpenAIRE |
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