Capillary leak syndrome cost-effectiveness of therapy: Difference between revisions
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==Overview== | ==Overview== | ||
The treatment of SCLS requires a combination of medications, and prices range according to severity of symptoms presented in individual patients. Whereas medication such as [[Bevacizumab]] can be $66.60 per 10 mg for 2 weeks, others like [[infliximab]] used for a duration of 5 mg/kg every 8 weeks may cost $99,171.00. It is also important to note that medication such as [[Theophylline]] and [[Terbutaline]] may accrue increased costs due to the neccesity of increased monitoring. | |||
==Cost-effective therapy== | ==Cost-effective therapy== | ||
Medications used can be divided based on classes, such as '''Endothelial signal transduction''' and '''Immune modulators.''' Prices vary for medications within every given class. | |||
{| class="wikitable" | {| class="wikitable" | ||
!Treatment | !Treatment | ||
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|'''[[Corticosteroids]]''' | |'''[[Corticosteroids]]''' | ||
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* [[Corticosteroids]] are commonly utilized to reduce underlying inflammation and has been used for SCLS | *[[Corticosteroids]] are commonly utilized to reduce underlying inflammation and has been used for SCLS | ||
* [[Septic shock]], one of the underlying causes SCLS, requires [[corticosteroids]] as part of the treatment regimen | *[[Septic shock]], one of the underlying causes SCLS, requires [[corticosteroids]] as part of the treatment regimen | ||
* [[Hydrocortisone]] use averaged around $1,254,078.00 per QALY<ref name="pmid32900325">{{cite journal| author=Thompson KJ, Taylor CB, Venkatesh B, Cohen J, Hammond NE, Jan S | display-authors=etal| title=The cost-effectiveness of adjunctive corticosteroids for patients with septic shock. | journal=Crit Care Resusc | year= 2020 | volume= 22 | issue= 3 | pages= 191-199 | pmid=32900325 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32900325 }}</ref> and a 90-day monetized benefit of $25,539 per patient<ref name="pmid32701552">{{cite journal| author=Oh M, Patanwala AE, Alkhatib N, Almutairi A, Abraham I, Erstad B| title=Cost Analysis of Adjunctive Hydrocortisone Therapy for Septic Shock: U.S. Payer Perspective. | journal=Crit Care Med | year= 2020 | volume= 48 | issue= 10 | pages= e906-e911 | pmid=32701552 | doi=10.1097/CCM.0000000000004501 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32701552 }}</ref> | *[[Hydrocortisone]] use averaged around $1,254,078.00 per QALY<ref name="pmid32900325">{{cite journal| author=Thompson KJ, Taylor CB, Venkatesh B, Cohen J, Hammond NE, Jan S | display-authors=etal| title=The cost-effectiveness of adjunctive corticosteroids for patients with septic shock. | journal=Crit Care Resusc | year= 2020 | volume= 22 | issue= 3 | pages= 191-199 | pmid=32900325 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32900325 }}</ref> and a 90-day monetized benefit of $25,539 per patient<ref name="pmid32701552">{{cite journal| author=Oh M, Patanwala AE, Alkhatib N, Almutairi A, Abraham I, Erstad B| title=Cost Analysis of Adjunctive Hydrocortisone Therapy for Septic Shock: U.S. Payer Perspective. | journal=Crit Care Med | year= 2020 | volume= 48 | issue= 10 | pages= e906-e911 | pmid=32701552 | doi=10.1097/CCM.0000000000004501 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32701552 }}</ref> | ||
|- | |- | ||
|'''[[Infliximab]]''' | |'''[[Infliximab]]''' | ||
| | | | ||
* Studies show that, compared to other immune modulators, [[infliximab]] was more cost-effective when given at 5 mg/kg every 8 weeks at $99,171.00. Comparatively, [[adalimumab]] given at 40 mg every other week totalled around $316,378 and [[vedolizumab]] given every 8 weeks averaged $301,969<ref name="pmid27195130">{{cite journal| author=Yokomizo L, Limketkai B, Park KT| title=Cost-effectiveness of adalimumab, infliximab or vedolizumab as first-line biological therapy in moderate-to-severe ulcerative colitis. | journal=BMJ Open Gastroenterol | year= 2016 | volume= 3 | issue= 1 | pages= e000093 | pmid=27195130 | doi=10.1136/bmjgast-2016-000093 | pmc=4860720 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27195130 }}</ref> | *Studies show that, compared to other immune modulators, [[infliximab]] was more cost-effective when given at 5 mg/kg every 8 weeks at $99,171.00. Comparatively, [[adalimumab]] given at 40 mg every other week totalled around $316,378 and [[vedolizumab]] given every 8 weeks averaged $301,969<ref name="pmid27195130">{{cite journal| author=Yokomizo L, Limketkai B, Park KT| title=Cost-effectiveness of adalimumab, infliximab or vedolizumab as first-line biological therapy in moderate-to-severe ulcerative colitis. | journal=BMJ Open Gastroenterol | year= 2016 | volume= 3 | issue= 1 | pages= e000093 | pmid=27195130 | doi=10.1136/bmjgast-2016-000093 | pmc=4860720 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27195130 }}</ref> | ||
|- | |- | ||
|'''[[IVIG]]''' | |'''[[IVIG]]''' | ||
| colspan="1" rowspan="1" | | | colspan="1" rowspan="1" | | ||
* Annual costs for IVIG in the USA during 2014 were on average $9,720 per infusion or $108,016 per patient<ref name="pmid33828522">{{cite journal| author=Burt RK, Tappenden P, Balabanov R, Han X, Quigley K, Snowden JA | display-authors=etal| title=The Cost Effectiveness of Immunoglobulin vs. Hematopoietic Stem Cell Transplantation for CIDP. | journal=Front Neurol | year= 2021 | volume= 12 | issue= | pages= 645263 | pmid=33828522 | doi=10.3389/fneur.2021.645263 | pmc=8019941 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33828522 }}</ref> | *Annual costs for IVIG in the USA during 2014 were on average $9,720 per infusion or $108,016 per patient<ref name="pmid33828522">{{cite journal| author=Burt RK, Tappenden P, Balabanov R, Han X, Quigley K, Snowden JA | display-authors=etal| title=The Cost Effectiveness of Immunoglobulin vs. Hematopoietic Stem Cell Transplantation for CIDP. | journal=Front Neurol | year= 2021 | volume= 12 | issue= | pages= 645263 | pmid=33828522 | doi=10.3389/fneur.2021.645263 | pmc=8019941 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33828522 }}</ref> | ||
* Other recent studies showed [[IVIG]] to be more cost-effective, averaging a cost of $78,814. When compared to [[plasmapheresis]], IVIG was found to be more cost-effective<ref name="pmid22361692">{{cite journal| author=Heatwole C, Johnson N, Holloway R, Noyes K| title=Plasma exchange versus intravenous immunoglobulin for myasthenia gravis crisis: an acute hospital cost comparison study. | journal=J Clin Neuromuscul Dis | year= 2011 | volume= 13 | issue= 2 | pages= 85-94 | pmid=22361692 | doi=10.1097/CND.0b013e31822c34dd | pmc=3291869 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22361692 }}</ref> | *Other recent studies showed [[IVIG]] to be more cost-effective, averaging a cost of $78,814. When compared to [[plasmapheresis]], IVIG was found to be more cost-effective<ref name="pmid22361692">{{cite journal| author=Heatwole C, Johnson N, Holloway R, Noyes K| title=Plasma exchange versus intravenous immunoglobulin for myasthenia gravis crisis: an acute hospital cost comparison study. | journal=J Clin Neuromuscul Dis | year= 2011 | volume= 13 | issue= 2 | pages= 85-94 | pmid=22361692 | doi=10.1097/CND.0b013e31822c34dd | pmc=3291869 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22361692 }}</ref> | ||
|- | |- | ||
|'''[[Plasmapheresis]]''' | |'''[[Plasmapheresis]]''' | ||
| | | | ||
* For use in inflammatory conditions, [[plasmapheresis]] costs averaged $101,140 per patient<ref name="pmid223616922">{{cite journal| author=Heatwole C, Johnson N, Holloway R, Noyes K| title=Plasma exchange versus intravenous immunoglobulin for myasthenia gravis crisis: an acute hospital cost comparison study. | journal=J Clin Neuromuscul Dis | year= 2011 | volume= 13 | issue= 2 | pages= 85-94 | pmid=22361692 | doi=10.1097/CND.0b013e31822c34dd | pmc=3291869 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22361692 }}</ref> | *For use in inflammatory conditions, [[plasmapheresis]] costs averaged $101,140 per patient<ref name="pmid223616922">{{cite journal| author=Heatwole C, Johnson N, Holloway R, Noyes K| title=Plasma exchange versus intravenous immunoglobulin for myasthenia gravis crisis: an acute hospital cost comparison study. | journal=J Clin Neuromuscul Dis | year= 2011 | volume= 13 | issue= 2 | pages= 85-94 | pmid=22361692 | doi=10.1097/CND.0b013e31822c34dd | pmc=3291869 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22361692 }}</ref> | ||
|} | |} | ||
Latest revision as of 06:38, 8 August 2022
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: M. Hassan, M.B.B.S
Overview
The treatment of SCLS requires a combination of medications, and prices range according to severity of symptoms presented in individual patients. Whereas medication such as Bevacizumab can be $66.60 per 10 mg for 2 weeks, others like infliximab used for a duration of 5 mg/kg every 8 weeks may cost $99,171.00. It is also important to note that medication such as Theophylline and Terbutaline may accrue increased costs due to the neccesity of increased monitoring.
Cost-effective therapy
Medications used can be divided based on classes, such as Endothelial signal transduction and Immune modulators. Prices vary for medications within every given class.
| Treatment | Mechanism of Action |
|---|---|
Endothelial signal transduction | |
| Bevacizumab |
|
| Epoprostenol |
|
| Theophylline + Terbutaline |
|
Immune modulation | |
| Corticosteroids |
|
| Infliximab |
|
| IVIG |
|
| Plasmapheresis |
|
References
- ↑ "Bevacizumab Wins Cost-Effectiveness Contest in First-Line Metastatic Colorectal Cancer". Am Health Drug Benefits. 8 (Spec Issue): 10–2. 2015. PMC 4570073. PMID 26380601.
- ↑ Petros AJ, Turner SC, Nunn AJ (1995). "Cost implications of using inhaled nitric oxide compared with epoprostenol for pulmonary hypertension". J Pharm Technol. 11 (4): 163–6. doi:10.1177/875512259501100409. PMID 10144080.
- ↑ Jubran A, Gross N, Ramsdell J, Simonian R, Schuttenhelm K, Sax M; et al. (1993). "Comparative cost-effectiveness analysis of theophylline and ipratropium bromide in chronic obstructive pulmonary disease. A three-center study". Chest. 103 (3): 678–84. doi:10.1378/chest.103.3.678. PMID 8449051.
- ↑ Hamilton RA, Gordon T (1992). "Incidence and cost of hospital admissions secondary to drug interactions involving theophylline". Ann Pharmacother. 26 (12): 1507–11. doi:10.1177/106002809202601202. PMID 1482803.
- ↑ Hayes E, Moroz L, Pizzi L, Baxter J (2007). "A cost decision analysis of 4 tocolytic drugs". Am J Obstet Gynecol. 197 (4): 383.e1–6. doi:10.1016/j.ajog.2007.06.052. PMID 17904969.
- ↑ Thompson KJ, Taylor CB, Venkatesh B, Cohen J, Hammond NE, Jan S; et al. (2020). "The cost-effectiveness of adjunctive corticosteroids for patients with septic shock". Crit Care Resusc. 22 (3): 191–199. PMID 32900325 Check
|pmid=value (help). - ↑ Oh M, Patanwala AE, Alkhatib N, Almutairi A, Abraham I, Erstad B (2020). "Cost Analysis of Adjunctive Hydrocortisone Therapy for Septic Shock: U.S. Payer Perspective". Crit Care Med. 48 (10): e906–e911. doi:10.1097/CCM.0000000000004501. PMID 32701552 Check
|pmid=value (help). - ↑ Yokomizo L, Limketkai B, Park KT (2016). "Cost-effectiveness of adalimumab, infliximab or vedolizumab as first-line biological therapy in moderate-to-severe ulcerative colitis". BMJ Open Gastroenterol. 3 (1): e000093. doi:10.1136/bmjgast-2016-000093. PMC 4860720. PMID 27195130.
- ↑ Burt RK, Tappenden P, Balabanov R, Han X, Quigley K, Snowden JA; et al. (2021). "The Cost Effectiveness of Immunoglobulin vs. Hematopoietic Stem Cell Transplantation for CIDP". Front Neurol. 12: 645263. doi:10.3389/fneur.2021.645263. PMC 8019941 Check
|pmc=value (help). PMID 33828522 Check|pmid=value (help). - ↑ Heatwole C, Johnson N, Holloway R, Noyes K (2011). "Plasma exchange versus intravenous immunoglobulin for myasthenia gravis crisis: an acute hospital cost comparison study". J Clin Neuromuscul Dis. 13 (2): 85–94. doi:10.1097/CND.0b013e31822c34dd. PMC 3291869. PMID 22361692.
- ↑ Heatwole C, Johnson N, Holloway R, Noyes K (2011). "Plasma exchange versus intravenous immunoglobulin for myasthenia gravis crisis: an acute hospital cost comparison study". J Clin Neuromuscul Dis. 13 (2): 85–94. doi:10.1097/CND.0b013e31822c34dd. PMC 3291869. PMID 22361692.