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Cost-effectiveness of treating infantile haemangioma with propranolol in an outpatient setting

Published online by Cambridge University Press:  26 July 2018

Kanupriya Chaturvedi ,
Joni S. Steinberg  and
Christopher S. Snyder
Kanupriya Chaturvedi
Affiliation:
The Congenital Heart Collaborative, Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA
Joni S. Steinberg
Affiliation:
Department of Global Health Management & Policy, Tulane University of Public Health and Tropical Medicine, New Orleans, LA, USA
Christopher S. Snyder*
Affiliation:
The Congenital Heart Collaborative, Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA
*
Author for correspondence: C. S. Snyder, MD, Division Chief, Department of Pediatric Cardiology, Rainbow Babies and Children’s Hospital, Case Western Reserve University, MS RBC 6011, 11100, Euclid Avenue, Cleveland, OH 44106, USA. Tel: 216 844 8529; Fax: 216 844 5478; E-mail: Christopher.Snyder@Uhhospitals.org
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Abstract

Background

Infantile haemangioma is one of the most commonly known benign vascular tumours of infancy and childhood, having an incidence of 3–10%. Most lesions regress spontaneously; however, some may require treatment owing to their clinical and cosmetic effects. Propranolol has become the treatment of choice for infantile haemangioma, but treatment protocols are largely institutional based without any specific consensus guidelines. Our aim was to evaluate the cost-effectiveness of propranolol use as inpatient versus outpatient therapy.

Methods

A decision tree model was created depicting alternate strategies for initiating propranolol treatment on an inpatient versus outpatient basis combined with the option of a pretreatment echocardiogram applied to both strategies. Cost analysis was assumed to be based on treatment of haemangioma in patients who were born at term, had no chronic illnesses, a non-life-threatening location of the haemangioma, and those who were not taking any other medications that could potentiate the side effects of propranolol. A sensitivity analysis was performed to evaluate the probability of side effects.

Results

The average cost incurred for inpatient treatment of infantile haemangioma was approximately $2603 for a single hospital day and increased to $2843 with the addition of an echocardiogram. The expected cost of treatment in the outpatient setting was $138, which increased to $828 after the addition of an echocardiogram.

Conclusion

Treating infantile haemangioma with propranolol is more cost-effective when initiated on an outpatient basis.

Keywords

Infantile haemangiomapropranololcost-effectiveness
Type
Original Article
Information
Cardiology in the Young , Volume 28 , Issue 10 , October 2018 , pp. 1105 - 1108
Copyright
© Cambridge University Press 2018 

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