Costs of bronchoalveolar lavage-directed therapy in the first 5 years of life for children with cystic fibrosis

Moodie, Marj, Lal, Anita, Vidmar, Suzanna, Armstrong, David S., Byrnes, Catherine A., Carlin, John B., Cheney, Joyce, Cooper, Peter J., Grimwood, Keith, Robertson, Colin F., Tiddens, Harm A. and Wainwright, Claire E. (2014) Costs of bronchoalveolar lavage-directed therapy in the first 5 years of life for children with cystic fibrosis. Journal of Pediatrics, 165 3: 564-569.e5. doi:10.1016/j.jpeds.2014.05.031


Author Moodie, Marj
Lal, Anita
Vidmar, Suzanna
Armstrong, David S.
Byrnes, Catherine A.
Carlin, John B.
Cheney, Joyce
Cooper, Peter J.
Grimwood, Keith
Robertson, Colin F.
Tiddens, Harm A.
Wainwright, Claire E.
Title Costs of bronchoalveolar lavage-directed therapy in the first 5 years of life for children with cystic fibrosis
Journal name Journal of Pediatrics   Check publisher's open access policy
ISSN 1097-6833
0022-3476
1085-8695
Publication date 2014-09
Year available 2014
Sub-type Article (original research)
DOI 10.1016/j.jpeds.2014.05.031
Open Access Status
Volume 165
Issue 3
Start page 564
End page 569.e5
Total pages 11
Place of publication Philadelphia, PA, United States
Publisher Mosby
Collection year 2015
Language eng
Formatted abstract
Objectives
To determine whether bronchoalveolar lavage (BAL)-directed therapy for infants and young children with cystic fibrosis (CF), rather than standard therapy, was justified on the grounds of a decrease in average costs and whether the use of BAL reduced treatment costs associated with hospital admissions.

Study design
Costs were assessed in a randomized controlled trial conducted in Australia and New Zealand on infants diagnosed with CF after newborn screening and assigned to receive either BAL-directed or standard therapy until they reached 5 years of age. A health care funder perspective was adopted. Resource use measurement was based on standardized data collection forms administered for patients across all sites. Unit costs were obtained primarily from government schedules.

Results
Mean costs per child during the study period were Australian dollars (AUD)92 860 in BAL-directed therapy group and AUD90 958 in standard therapy group (mean difference AUD1902, 95% CI AUD−27 782 to 31 586, P = .90). Mean hospital costs per child during the study period were AUD57 302 in the BAL-directed therapy group and AUD66 590 in the standard therapy group (mean difference AUD−9288; 95% CI AUD−35 252 to 16 676, P = .48).

Conclusions
BAL-directed therapy did not result in either lower mean hospital admission costs or mean costs overall compared with managing patients with CF by a standard protocol based upon clinical features and oropharyngeal culture results alone. Following on our previous findings that BAL-directed treatment offers no clinical advantage over standard therapy at age 5 years, flexible bronchoscopy with BAL cannot be recommended for the routine management of preschool children with CF on the basis of overall cost savings.
Keyword Australian dollars
Bronchoalveolar lavage
Cystic fibrosis
Diagnosis-related group
New Zealand
Oropharyngeal
Pharmaceutical Benefits Schedule
Pharmaceutical Management Agency of New Zealand
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
Queensland Children's Medical Research Institute Publications
School of Medicine Publications
 
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