TY  - JOUR
AU  - Gc, VS
AU  - Franklin, D
AU  - Whitty, JA
AU  - Dalziel, SR
AU  - Babl, FE
AU  - Schlapbach, LJ
AU  - Fraser, JF
AU  - Craig, S
AU  - Neutze, J
AU  - Oakley, E
AU  - Schibler, A
Y2  - 2020/12/14
Y1  - 2020/10/01
SN  - 0003-9888
UR  - http://hdl.handle.net/11343/254068
AB  - BACKGROUND: Bronchiolitis is the most common reason for hospital admission in infants. High-flow oxygen therapy has emerged as a new treatment; however, the cost-effectiveness of using it as first-line therapy is unknown. OBJECTIVE: To compare the cost of providing high-flow therapy as a first-line therapy compared with rescue therapy after failure of standard oxygen in the management of bronchiolitis. METHODS: A within-trial economic evaluation from the health service perspective using data from a multicentre randomised controlled trial for hypoxic infants (≤12 months) admitted to hospital with bronchiolitis in Australia and New Zealand. Intervention costs, length of hospital and intensive care stay and associated costs were compared for infants who received first-line treatment with high-flow therapy (early high-flow, n=739) or for infants who received standard oxygen and optional rescue high-flow (rescue high-flow, n=733). Costs were applied using Australian costing sources and are reported in 2016-2017 AU$. RESULTS: The incremental cost to avoid one treatment failure was AU$1778 (95% credible interval (CrI) 207 to 7096). Mean cost of bronchiolitis treatment including intervention costs and costs associated with length of stay was AU$420 (95% CrI -176 to 1002) higher per infant in the early high-flow group compared with the rescue high-flow group. There was an 8% (95% CrI 7.5 to 8.6) likelihood of the early high-flow oxygen therapy being cost saving. CONCLUSIONS: The use of high-flow oxygen as initial therapy for respiratory failure in infants with bronchiolitis is unlikely to be cost saving to the health system, compared with standard oxygen therapy with rescue high-flow.
LA  - English
PB  - BMJ PUBLISHING GROUP
T1  - First-line oxygen therapy with high-flow in bronchiolitis is not cost saving for the health service
DO  - 10.1136/archdischild-2019-318427
IS  - Archives of Disease in Childhood
VL  - 105
IS  - 10
SP  - 975-980
ER  -