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Economic evaluation of intravenous immune globulin therapy for Kawasaki syndrome.
Klassen, T P; Rowe, P C; Gafni, A.
Afiliação
  • Klassen TP; Department of Pediatrics, University of Ottawa, Ontario, Canada.
J Pediatr ; 122(4): 538-42, 1993 Apr.
Article em En | MEDLINE | ID: mdl-8463897
OBJECTIVE: To determine the costs and clinical outcomes of three alternative treatments of the acute phase of Kawasaki syndrome: aspirin alone; low doses of intravenously administered immune globulin (IVIG-LD), 400 mg/kg per dose for 4 days; and high doses of intravenously administered immune globulin (IVIG-HD), 2.0 gm/kg for one dose. DESIGN: A model was developed that assumed the inclusion of 100 patients with acute Kawasaki syndrome in each treatment option. Costs were valued by using the Chedoke-McMaster Corporate Cost Model in 1992 Canadian dollars. Clinical outcome, based on the published literature, was measured by the prevalence of coronary artery dilation at 7 weeks from the diagnosis of Kawasaki syndrome. RESULTS: For every 100 patients with Kawasaki syndrome, the cost was reduced by $323,400 when aspirin therapy alone was changed to IVIG-HD therapy and 14 cases of coronary artery dilation were thereby prevented. When IVIG-HD therapy was compared with IVIG-LD therapy, the cost was reduced by $118,200 because two cases of coronary artery aneurysm were prevented. This latter result was sensitive to the duration of hospitalization, with IVIG-HD costing $8500 more for every 100 patients than IVIG-LD when it was assumed that both groups were hospitalized for 5 days, an unlikely occurrence. CONCLUSIONS: Treatment with IVIG-HD for Kawasaki syndrome is preferred because it results in both lower costs and lower rates of coronary artery dilation.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Imunoglobulinas Intravenosas / Síndrome de Linfonodos Mucocutâneos Tipo de estudo: Health_economic_evaluation / Prognostic_studies / Risk_factors_studies Limite: Child / Humans Idioma: En Revista: J Pediatr Ano de publicação: 1993 Tipo de documento: Article País de afiliação: Canadá País de publicação: Estados Unidos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Imunoglobulinas Intravenosas / Síndrome de Linfonodos Mucocutâneos Tipo de estudo: Health_economic_evaluation / Prognostic_studies / Risk_factors_studies Limite: Child / Humans Idioma: En Revista: J Pediatr Ano de publicação: 1993 Tipo de documento: Article País de afiliação: Canadá País de publicação: Estados Unidos