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Cost-effectiveness analysis of phenotypic-guided vs. guidelines-guided bronchodilator therapy in viral bronchiolitis
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  • Carlos Rodriguez-Martinez,
  • Gustavo Nino,
  • Jose Castro-Rodriguez,
  • Geovanny F. Perez,
  • Monica Sossa-Briceño,
  • jefferson buendia
Carlos Rodriguez-Martinez
School of Medicine, Universidad El Bosque
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Gustavo Nino
Pennsylvania State University / Penn State Children's Hospital
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Jose Castro-Rodriguez
Pontificia Universidad Catolica de Chile
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Geovanny F. Perez
The George Washington University
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Monica Sossa-Briceño
Universidad Nacional de Colombia
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jefferson buendia
University of Antioquia
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Abstract

Objectives. Although recent evidence suggests that management of viral bronchiolitis requires something other than guidelines-guided therapy, there is a lack of evidence supporting the economic benefits of phenotypic-guided bronchodilator therapy for treating this disease. The aim of the present study was to compare the cost-effectiveness of phenotypic-guided versus guidelines-guided bronchodilator therapy in infants with viral bronchiolitis. Methods: A decision‐analysis model was developed in order to compare the cost-effectiveness of phenotypic-guided versus guidelines-guided bronchodilator therapy in infants with viral bronchiolitis. The effectiveness parameters and costs of the model were obtained from electronic medical records. The main outcome was avoidance of hospital admission after initial care in the ED. Results: Compared to guidelines-guided strategy, treating patients with viral bronchiolitis with the phenotypic-guided bronchodilator therapy strategy was associated with lower total costs (US$250.99 vs US$263.46 average cost per patient) and a higher probability of avoidance of hospital admission (0.7902 vs 0.7638), thus leading to dominance. Results were robust to deterministic and probabilistic sensitivity analyses. Conclusions: Compared to guidelines-guided strategy, treating infants with viral bronchiolitis using the phenotypic-guided bronchodilator therapy strategy is a more cost-effective strategy, because it involves a lower probability of hospital admission at lower total treatment costs.

Peer review status:UNDER REVIEW

30 Jul 2020Submitted to Pediatric Pulmonology
30 Jul 2020Submission Checks Completed
30 Jul 2020Assigned to Editor
01 Aug 2020Reviewer(s) Assigned
03 Sep 2020Review(s) Completed, Editorial Evaluation Pending
04 Sep 2020Editorial Decision: Revise Major
10 Sep 20201st Revision Received
11 Sep 2020Assigned to Editor
11 Sep 2020Submission Checks Completed
11 Sep 2020Reviewer(s) Assigned