Doxycycline Added to Prednisolone in Outpatient-Treated Acute Exacerbations of COPD
| العنوان: | Doxycycline Added to Prednisolone in Outpatient-Treated Acute Exacerbations of COPD |
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| المؤلفون: | Jan M. Prins, Judith E. Bosmans, Patricia van Velzen, Gerben ter Riet, Peter J. Sterk, Aureliano Paolo Finch |
| المساهمون: | Graduate School, AII - Inflammatory diseases, APH - Aging & Later Life, APH - Personalized Medicine, General practice, Pulmonology, Infectious diseases, Health Economics and Health Technology Assessment, APH - Mental Health, APH - Methodology |
| المصدر: | PharmacoEconomics, 37(5), 689-699. Adis International Ltd Finch, A P, van Velzen, P, Ter Riet, G, Sterk, P J, Prins, J M & Bosmans, J E 2019, ' Doxycycline Added to Prednisolone in Outpatient-Treated Acute Exacerbations of COPD : A Cost-Effectiveness Analysis Alongside a Randomised Controlled Trial ', PharmacoEconomics, vol. 37, no. 5, pp. 689-699 . https://doi.org/10.1007/s40273-018-0756-9Test |
| بيانات النشر: | Adis International Ltd, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Exacerbation, Cost-Benefit Analysis, Prednisolone, Placebo, Severity of Illness Index, law.invention, Cohort Studies, 03 medical and health sciences, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Randomized controlled trial, SDG 3 - Good Health and Well-being, law, Internal medicine, Outpatients, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Aged, Pharmacology, Doxycycline, COPD, business.industry, 030503 health policy & services, Health Policy, Public Health, Environmental and Occupational Health, Cost-effectiveness analysis, medicine.disease, Symptom Flare Up, Confidence interval, Treatment Outcome, Drug Therapy, Combination, Female, Quality-Adjusted Life Years, 0305 other medical science, business, medicine.drug |
| الوصف: | BACKGROUND: Most patients with mild to severe chronic obstructive pulmonary disease (COPD) experience exacerbations, which are also associated with increased healthcare costs. Despite limited evidence of antibiotics' benefits for exacerbations in outpatients, antibiotics are frequently prescribed. The aim of this study was to investigate whether doxycycline added to prednisolone is cost-effective compared to placebo plus prednisolone for the treatment of COPD acute exacerbations.METHODS: An economic evaluation from the societal perspective was performed alongside a 2-year randomised trial in 301 COPD patients in the Netherlands. The primary outcome was cost per quality-adjusted life year (QALY). The secondary outcome was cost per exacerbation prevented. Healthcare utilisation and loss of productivity were measured using retrospective questionnaires and clinical report forms. Missing data were imputed using multiple imputations by chained equations. Bootstrapping was employed to estimate statistical uncertainty surrounding cost-effectiveness outcomes. A sensitivity analysis from the healthcare perspective was performed.RESULTS: On average, costs in the doxycycline group were €898 higher than in the placebo group [95% confidence interval (CI) - 2617 to 4409] for the 2 years of follow-up. QALY values were higher in the doxycycline group (0.03; 95% CI - 0.00 to 0.06), but patients in this group suffered 0.01 more exacerbations than patients in the placebo group (95% CI - 0.14 to 0.11). Cost-effectiveness acceptability curves showed that the probability of doxycycline being cost-effective compared to placebo was 61% and 43% at a willingness-to-pay threshold of €34,000 per QALY and per exacerbation avoided, respectively. The sensitivity analysis showed similar results from the healthcare system perspective.CONCLUSIONS: In patients with mild to severe COPD treated for exacerbations in an outpatient setting, doxycycline added to prednisolone is not cost-effective compared to prednisolone plus placebo over a 2-year period. |
| اللغة: | English |
| تدمد: | 1170-7690 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::75e1f1fcb4a60b1c866b9ea1911d493dTest https://doi.org/10.1007/s40273-018-0756-9Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....75e1f1fcb4a60b1c866b9ea1911d493d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 11707690 |
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