An Economic Evaluation of Two Ototopical Treatments for Acute Otitis Media in Tympanostomy Tube Patients

Jul 1, 2006, 00:00
10.1111/j.1524-4733.2006.00105.x
https://www.valueinhealthjournal.com/article/S1098-3015(10)60273-2/fulltext
Title : An Economic Evaluation of Two Ototopical Treatments for Acute Otitis Media in Tympanostomy Tube Patients
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(10)60273-2&doi=10.1111/j.1524-4733.2006.00105.x
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Section Title :
Open access? : No
Section Order : 3

Objective

The goal of this research was to determine the cost-effectiveness of ciprofloxacin 0.3%/dexamethasone 0.1% (CD) otic suspension versus ofloxacin 0.3% otic solution (OFX) for treatment of acute otitis media in tympanostomy tube patients.

Methods

A decision-analytic model was used to emulate the ototopical treatment of acute otitis media in patients with tympanostomy tubes. The economic outcome was the cost per otorrhea-free day (OFD) achieved per episode of care. Three tiers of antimicrobial therapy were modeled, with each successive tier representing the retreatment of clinical failures from the preceding tier. First-tier therapy compared CD and OFX using outcome measures obtained from a randomized clinical trial (n = 599). Second-tier therapy modeled the use of amoxicillin/clavulanate (ACA) using outcome measures obtained from a physician survey and medical literature. Third-tier therapy was modeled as pathogen-specific and curative. It could follow one of three pathways: 1) intramuscular ceftriaxone; 2) oral fluconazole; or 3) hospitalization for intravenous antibiotics. Third-tier outcomes were based on a physician survey. Cost data were obtained from standard references and presented from a payer perspective.

Results

The expected therapeutic costs were $249.40 for the CD pathway and $265.44 for the OFX pathway. The estimated number of OFDs per episode of care was 25.88 for the CD pathway and 23.86 for the OFX pathway. The cost-effectiveness ratios for CD and OFX therapies were $9.64 and $11.13 per OFD, respectively.

Conclusion

CD is both more effective and less costly than OFX for the treatment of acute otitis media in patients with tympanostomy tubes.

Categories :
  • Cost-comparison, Effectiveness, Utility, Benefit Analysis
  • Decision Modeling & Simulation
  • Economic Evaluation
  • Sensory System Disorders
  • Specific Diseases & Conditions
  • Study Approaches
Tags :
  • ciprofloxacin
  • cost-effectiveness
  • decision analysis
  • dexamethasone
  • ofloxacin
  • otorrhea
  • tympanostomy
Regions :
  • North America
ViH Article Tags :