医学
抗生素
肺炎
安慰剂
社区获得性肺炎
重症监护医学
成本效益
肺炎严重指数
内科学
风险分析(工程)
替代医学
生物
微生物学
病理
作者
Elina Eleftheria Pliakos,Nikolaos Andreatos,Giannoula S. Tansarli,Panayiotis D. Ziakas,Eleftherios Mylonakis
出处
期刊:Chest
[Elsevier]
日期:2019-04-01
卷期号:155 (4): 787-794
被引量:10
标识
DOI:10.1016/j.chest.2018.11.001
摘要
The use of corticosteroids as adjunct treatment for community-acquired pneumonia (CAP) is associated with potential clinical benefits. The aim of this study was to evaluate the cost-effectiveness of this approach.We constructed a decision-analytic model comparing the use of corticosteroids + antibiotics with that of placebo + antibiotics for the treatment of CAP. Cost-effectiveness was determined by calculating deaths averted and incremental cost-effectiveness ratios. Uncertainty was addressed by plotting cost-effectiveness planes and acceptability curves for various willingness-to-pay thresholds.In the base-case analysis, corticosteroids + antibiotics resulted in savings of $142,795 per death averted. In the probabilistic analysis, at a willingness to pay of $50,000, corticosteroids + antibiotics had a 86.4% chance of being cost-effective compared with placebo + antibiotics. In cost-effectiveness acceptability curves, the corticosteroids + antibiotics strategy was cost-effective in 87.6% to 94.3% of simulations compared with the placebo + antibiotics strategy for a willingness to pay ranging from $0 to $50,000. In patients with severe CAP (Pneumonia Severity Index classes IV/V) the corticosteroids + antibiotics strategy resulted in savings of $70,587 and had a 82.6% chance of being cost-effective compared with the placebo + antibiotics strategy.The use of corticosteroids + antibiotics is a cost-effective strategy and results in considerable health care cost-savings, especially among patients with severe CAP (Pneumonia Severity Index classes IV/V).
科研通智能强力驱动
Strongly Powered by AbleSci AI