Hydroxyurea Is Associated With Lower Costs of Care of Young Children With Sickle Cell Anemia
Hydroxyurea Is Associated With Lower Costs of Care of Young Children With Sickle Cell Anemia
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DOI：
10.1542/peds.2013-0333
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发表时间：
2013-10-01
期刊：
影响因子：
8
通讯作者：
Grosse, Scott D.
中科院分区：
文献类型：
--
作者：
Wang, Winfred C.;Oyeku, Suzette O.;Grosse, Scott D.
背景与目的：在BABY HUG试验中，随机接受羟脲治疗的镰状细胞性贫血患儿疼痛、住院和输血的发生率较低。随着羟基脲在这一人群中的广泛使用，我们试图估计治疗与未治疗儿童的医疗费用。方法：使用BABY HUG数据库比较接受羟基脲治疗和安慰剂治疗的住院事件。根据2009年MarketScan多州医疗补助数据库对1 - 3岁镰状细胞病儿童的单位成本进行估算。住院费用以住院时间为基础，根据急性胸综合征、脾隔离或输血的发生情况进行调整。门诊费用是基于婴儿拥抱所需的时间表和1至3岁镰状细胞性贫血儿童的“标准”时间表。结果：羟脲组有232例住院，安慰剂组有324例住院；两组患者住院时间相似。在接受羟基脲治疗的患者中，估计门诊费用更高，但这些费用被住院费用所掩盖。羟基脲组的总估计年成本（11,072美元）比安慰剂组的成本（13,962美元；P = 0.038）低21%。结论：与接受安慰剂的儿童相比，接受羟基脲治疗的镰状细胞性贫血儿童的住院治疗费用显著降低。由于成本节约可能随着年龄的增长而增加，这些数据为在这一人群中广泛使用羟基脲治疗提供了额外的支持。
BACKGROUND AND OBJECTIVE: In the BABY HUG trial, young children with sickle cell anemia randomized to receive hydroxyurea had fewer episodes of pain, hospitalization, and transfusions. With anticipated broader use of hydroxyurea in this population, we sought to estimate medical costs of care in treated versus untreated children.METHODS: The BABY HUG database was used to compare inpatient events in subjects receiving hydroxyurea with those receiving placebo. Unit costs were estimated from the 2009 MarketScan Multi-state Medicaid Database for children with sickle cell disease, aged 1 to 3 years. Inpatient costs were based on length of hospital stay, modified by the occurrence of acute chest syndrome, splenic sequestration, or transfusion. Outpatient expenses were based on the schedule required for BABY HUG and a "standard" schedule for 1- to 3-year-olds with sickle cell anemia.RESULTS: There were 232 hospitalizations in the subjects receiving hydroxyurea and 324 in those on placebo; length of hospital stay was similar in the 2 groups. Estimated outpatient expenses were greater in those receiving hydroxyurea, but these were overshadowed by inpatient costs. The total estimated annual cost for those on hydroxyurea ($11 072) was 21% less than the cost of those on placebo ($13 962; P = .038).CONCLUSIONS: Savings on inpatient care resulted in a significantly lower overall estimated medical care cost for young children with sickle cell anemia who were receiving hydroxyurea compared with those receiving placebo. Because cost savings are likely to increase with age, these data provide additional support for broad use of hydroxyurea treatment in this population.