The economic impact of intermittent high-dose intravenous versus oral corticosteroid treatment of juvenile dermatomyositis

Arthritis Care Res. 2000 Dec;13(6):360-8. doi: 10.1002/1529-0131(200012)13:6<360::aid-art5>3.0.co;2-q.

Abstract

Objective: To perform a cost-identification and cost-effectiveness analysis comparing oral corticosteroids (OCS) with high-dose intermittent intravenous corticosteroid (IVCS) regimens in the treatment of juvenile dermatomyositis (JDM).

Methods: Children previously diagnosed and treated for JDM (without myositis-specific or myositis-associated autoantibodies) at a single medical center by a single provider were identified. Two treatment protocols were compared: OCS and IVCS. Data on initial disease severity, time to remission, resource use, and costs generated were collected from patient records. Incremental cost-effectiveness ratios (ICE) were constructed.

Results: Patients treated with IVCS achieved median remission 2 years earlier at median increased cost of $13,736. The ICE ratio comparing IVCS to OCS is $6,868 per year of disease avoided.

Conclusion: This study suggests that, although IVCS treatments are costly, they are cost-effective.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral*
  • Adrenal Cortex Hormones / administration & dosage*
  • Adrenal Cortex Hormones / economics*
  • Chicago
  • Child, Preschool
  • Cost Savings
  • Cost of Illness
  • Cost-Benefit Analysis
  • Dermatomyositis / drug therapy*
  • Dermatomyositis / economics*
  • Direct Service Costs / statistics & numerical data
  • Drug Costs / statistics & numerical data
  • Female
  • Health Resources / economics
  • Health Resources / statistics & numerical data
  • Hospital Costs / statistics & numerical data
  • Hospitals, Pediatric
  • Humans
  • Infusions, Intravenous / economics*
  • Length of Stay / economics
  • Male
  • Remission Induction / methods
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones