PMID- 25394502
OWN - NLM
STAT- MEDLINE
DCOM- 20151123
LR  - 20210109
IS  - 1471-6348 (Electronic)
IS  - 0266-4623 (Linking)
VI  - 30
IP  - 4
DP  - 2014 Oct
TI  - Economic evaluation of nebulized magnesium sulphate in acute severe asthma in 
      children.
PG  - 354-60
LID - 10.1017/S0266462314000440 [doi]
AB  - OBJECTIVES: The aim of this study was to estimate the cost-effectiveness of 
      nebulized magnesium sulphate (MgSO4) in acute asthma in children from the 
      perspective of the UK National Health Service and personal social services. 
      METHODS: An economic evaluation was conducted based on evidence from a randomized 
      placebo controlled multi-center trial of nebulized MgSO4 in severe acute asthma 
      in children. Participants comprised 508 children aged 2-16 years presenting to an 
      emergency department or a children's assessment unit with severe acute asthma 
      across thirty hospitals in the United Kingdom. Children were randomly allocated 
      to receive nebulized salbutamol and ipratropium bromide mixed with either 2.5 ml 
      of isotonic MgSO4 or 2.5 ml of isotonic saline on three occasions at 20-min 
      intervals. Cost-effectiveness outcomes were constructed around the Yung Asthma 
      Severity Score (ASS) after 60 min of treatment; whilst cost-utility outcomes were 
      constructed around the quality-adjusted life-year (QALY) metric. The 
      nonparametric bootstrap method was used to present cost-effectiveness 
      acceptability curves at alternative cost-effectiveness thresholds for either: (i) 
      a unit reduction in ASS; or (ii) an additional QALY. RESULTS: MgSO4 had a 75.1 
      percent probability of being cost-effective at a GBP 1,000 (EUR 1,148) per unit 
      decrement in ASS threshold, an 88.0 percent probability of being more effective 
      (in terms of reducing the ASS) and a 36.6 percent probability of being less 
      costly. MgSO4 also had a 67.6 percent probability of being cost-effective at a 
      GBP 20,000 (EUR 22,957) per QALY gained threshold, an 8.5 percent probability of 
      being more effective (in terms of generating increased QALYs) and a 69.1 percent 
      probability of being less costly. Sensitivity analyses showed that the results of 
      the economic evaluation were particularly sensitive to the methods used for QALY 
      estimation. CONCLUSIONS: The probability of cost-effectiveness of nebulized 
      isotonic MgSO4, given as an adjuvant to standard treatment of severe acute asthma 
      in children, is less than 70 percent across accepted cost-effectiveness 
      thresholds for an additional QALY.
FAU - Petrou, Stavros
AU  - Petrou S
AD  - Warwick Clinical Trials Unit,Division of Health Sciences,University of 
      Warwicks.petrou@warwick.ac.uk.
FAU - Boland, Angela
AU  - Boland A
AD  - Liverpool Reviews and Implementation Group,University of Liverpool.
FAU - Khan, Kamran
AU  - Khan K
AD  - Warwick Clinical Trials Unit,Division of Health Sciences,University of Warwick.
FAU - Powell, Colin
AU  - Powell C
AD  - School of Medicine,Cardiff University.
FAU - Kolamunnage-Dona, Ruwanthi
AU  - Kolamunnage-Dona R
AD  - Department of Biostatistics,University of Liverpool.
FAU - Lowe, John
AU  - Lowe J
AD  - School of Medicine,Cardiff University;Department of Biostatistics,University of 
      Liverpool.
FAU - Doull, Iolo
AU  - Doull I
AD  - Department of Respiratory Paediatrics,Children's Hospital for Wales.
FAU - Hood, Kerry
AU  - Hood K
AD  - School of Medicine,Cardiff University.
FAU - Williamson, Paula
AU  - Williamson P
AD  - Department of Respiratory Paediatrics,Children's Hospital for Wales.
LA  - eng
GR  - 05/503/10/DH_/Department of Health/United Kingdom
GR  - G0501681/MRC_/Medical Research Council/United Kingdom
GR  - G0700452/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20141114
PL  - England
TA  - Int J Technol Assess Health Care
JT  - International journal of technology assessment in health care
JID - 8508113
RN  - 0 (Bronchodilator Agents)
RN  - 7487-88-9 (Magnesium Sulfate)
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Asthma/*drug therapy
MH  - Bronchodilator Agents/administration & dosage/*economics
MH  - Child
MH  - Child, Preschool
MH  - Humans
MH  - Magnesium Sulfate/administration & dosage/*economics
MH  - Nebulizers and Vaporizers
MH  - Technology Assessment, Biomedical
OTO - NOTNLM
OT  - Magnesium sulphate
EDAT- 2014/11/15 06:00
MHDA- 2015/12/15 06:00
CRDT- 2014/11/15 06:00
PHST- 2014/11/15 06:00 [entrez]
PHST- 2014/11/15 06:00 [pubmed]
PHST- 2015/12/15 06:00 [medline]
AID - S0266462314000440 [pii]
AID - 10.1017/S0266462314000440 [doi]
PST - ppublish
SO  - Int J Technol Assess Health Care. 2014 Oct;30(4):354-60. doi: 
      10.1017/S0266462314000440. Epub 2014 Nov 14.