Economic evaluation of botulinum toxin versus thoracic sympathectomy for palmar hyperhidrosis: Data from a real-world scenario

被引:6
作者
Isla-Tejera B. [1 ]
Ruano J. [2 ]
Álvarez M.A. [2 ]
Brieva T. [1 ]
Cárdenas M. [1 ]
Baamonde C. [3 ]
Salvatierra Á. [3 ]
del Prado-Llergo J.-R. [1 ]
Moreno-Giménez J.C. [2 ]
机构
[1] Department of Pharmacy, Reina Sofia University Hospital, 14004 Córdoba, Avda. Menéndez Pidal s/n
[2] Department of Dermatology, Reina Sofia University Hospital, Córdoba
[3] Department of Thoracic Surgery, Reina Sofia University Hospital, Córdoba
关键词
Botulinum toxin; Endoscopic thoracic sympathectomy; Incremental cost-effectiveness analysis; Palmar hyperhidrosis;
D O I
10.1007/s13555-013-0025-y
中图分类号
学科分类号
摘要
Introduction: Local botulinum toxin injections and endoscopic thoracic sympathectomy (ETS) have shown clinical effectiveness for the treatment of palmar hyperhidrosis in several studies. Although both strategies cause considerable costs for health-care systems, at the moment there are no studies examining directly their cost-effectiveness performance. The aim of the study was to assess the incremental cost-effectiveness of botulinum toxin when compared with ETS for palmar hyperhidrosis. Materials and Methods: Costs, effectiveness, and incremental cost-effectiveness ratio (ICER) were calculated. Costs were assessed from a Spanish National Health System perspective in a historical cohort of patients with palmar hyperhidrosis attending a tertiary referral hospital. Effectiveness was evaluated by using the Hyperhidrosis Disease Severity Scale (HDSS). A responder was defined as a patient who reported at least a two-grade improvement on the HDSS scale with respect to the baseline value. The horizon of time was 1 year. Results: Effectiveness was greater for ETS (n = 128) when compared with botulinum toxin (n = 100) for the treatment of palmar hyperhidrosis (92% vs. 68%; odds ratio (OR) = 6.22 [2.80, 13.80]; absolute risk ratio (ARR)=-0.24 [-0.45, -0.14]; number-neededto- treat (NNT)=-4 [-2, -11]). Botulinum toxin had an ICER of 125 € when compared with ETS during the first year of treatment. Conclusions: In this retrospective real-world observational sample of patients with palmar hyperhidrosis, treatment with ETS appears to be more effective and less costly when compared with botulinum toxin during the first year of treatment. Analyses such as this give decision makers the tools to choose a better treatment option which is both highly effective and yet has a low cost. © The Author(s) 2013.
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页码:63 / 72
页数:9
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