Direct medical costs of pediatric asthma exacerbations requiring hospital attendance in a middle-income country

Dexamethasone or prednisolone for asthma exacerbations in children: A cost‐effectiveness analysis

“…Unit costs and resource utilization data were obtained from a recent study aimed at evaluating the direct medical costs associated with pediatric acute asthma in Bogota, Colombia. 16 Because the appropriate dosages of dexamethasone and prednisolone in children depend on weight, we defined three groups of children in a way similar to what was done in Andrews et al 13 The study protocol was approved by the local research and ethics committee.…”

“…Costs and utilization of resourcesBecause a third-party payer perspective was used for the CEA, direct costs were the only costs considered in the model. Unit costs and resource utilization data were obtained from a recent study aimed at evaluating the direct medical costs associated with pediatric acute asthma in Bogota, Colombia 16. Because the appropriate dosages of dexamethasone and prednisolone in children depend on weight, we defined three groupsof children in a way similar to what was done in Andrews et al 13 : a group of 2-year-olds at the 50th percentile by weight (12 kg), a group of 8-year-olds at the 50th percentile by weight (25 kg), and a group of 17-year-olds at the 50th percentile by weight (70 kg).…”

The use of ipratropium bromide for treating moderate to severe asthma exacerbations in pediatric patients in an emergency setting: A cost‐effectiveness analysis

“…Specifically, the costs of IB, consumables (fluids and supplies), medical and therapy services (including respiratory therapy), diagnostics tests and procedures (hemogram, C-reactive protein, and imagenologic studies), and hotel services (hospital stay) were included. 3 Due to the fact that IB is always given with SABAs and its administration involves little additional manipulation, the costs of SABAs, nursing time, wall oxygen, and disposable nebulizer equipment, including nebulizer bowls and masks, were not considered in the cost analysis, since they were assumed to be similar for both treatment groups. Since IB nebules are not usually transferable or reusable between patients, the cost of IB nebules was calculated by using the cost of one IB nebule per patient.…”

“…This hospital is a pediatric clinic located in Bogota, the capital city of Colombia, that receives patients from the majority of and the most representative medical insurance companies in the country, and consequently, the cost data gathered were considered to be reasonably well representative of the asthma costs in the whole country. 3 In the study from which the costs of asthma exacerbations were derived, the patients were divided into four groups: those admitted to the ED only, those admitted to the pediatric ward, those admitted to the pediatric intermediate care unit, and those admitted to the pediatric intensive care unit. However, because the percentage of admissions for asthma to hospital services in a referral hospital may not be generalizable to a broader and general asthma population, the average cost per exacerbation included in the model was calculated by means of a weighted average of the probability of requiring admission to different hospital services for asthma exacerbations as reported in the literature.…”

“…1 This is because acute asthma exacerbations and the consequent need for emergency department (ED) treatment and/ or hospital admission are responsible for the largest part of direct health costs for asthma and almost all of the indirect costs of the disease in most countries. 2,3 The first-line medications for treating pediatric asthma exacerbations in the ED setting are inhaled short-acting β2-agonists (SABAs) and systemic corticosteroids (SCs). 4 Moreover, the addition of anticholinergic agents may also be useful in the early stages of treatment, particularly in moderate to severe exacerbations, because of increased cholinergic bronchomotor tone.…”