BACKGROUND: Sinusitis is a common medical disease with a tremendous economic impact on health care. Our objective was to determine the most cost-effective strategy for the management of acute sinusitis from the societal and payers' perspectives. METHODS: A Markov disease simulation model was used for comparing four treatment strategies: (1) no antibiotic (Abx), (2) empiric Abx, (3) CT-based Abx, and (4) clinical guideline-based Abx. RESULTS: Empiric Abx treatment was the most cost-effective from the societal perspective. Clinical guideline-based treatment was the most cost-effective strategy from the payers' perspective ($38,515/quality-adjusted life year). Cost and effectiveness of Abx, time lost from work, and prevalence of acute bacterial sinusitis are influential variables. CONCLUSION: Empiric Abx treatment is a cost-effective strategy from the short-term societal perspective. However, Abx resistance will lead to increased costs and reduced efficacy of this strategy in the long-term. Clinical guidelines provide a low-cost method of targeting therapy.
BACKGROUND:Sinusitis is a common medical disease with a tremendous economic impact on health care. Our objective was to determine the most cost-effective strategy for the management of acute sinusitis from the societal and payers' perspectives. METHODS: A Markov disease simulation model was used for comparing four treatment strategies: (1) no antibiotic (Abx), (2) empiric Abx, (3) CT-based Abx, and (4) clinical guideline-based Abx. RESULTS: Empiric Abx treatment was the most cost-effective from the societal perspective. Clinical guideline-based treatment was the most cost-effective strategy from the payers' perspective ($38,515/quality-adjusted life year). Cost and effectiveness of Abx, time lost from work, and prevalence of acute bacterial sinusitis are influential variables. CONCLUSION: Empiric Abx treatment is a cost-effective strategy from the short-term societal perspective. However, Abx resistance will lead to increased costs and reduced efficacy of this strategy in the long-term. Clinical guidelines provide a low-cost method of targeting therapy.
Authors: Stephanie S Smith; Elisabeth H Ference; Charlesnika T Evans; Bruce K Tan; Robert C Kern; Rakesh K Chandra Journal: Laryngoscope Date: 2014-09-17 Impact factor: 3.325
Authors: Stephanie Shintani Smith; Robert C Kern; Rakesh K Chandra; Bruce K Tan; Charlesnika T Evans Journal: Otolaryngol Head Neck Surg Date: 2013-03-05 Impact factor: 3.497
Authors: Krupa R Patel; David J Phillips; Jason M Leibowitz; Theresa Scognamiglio; Victoria E Banuchi; William I Kuhel; David I Kutler; Marc A Cohen Journal: World J Otorhinolaryngol Head Neck Surg Date: 2016-01-26