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Cost Effectiveness and Cost Utility of Acetylcysteine versus Dimethyl Sulfoxide for Reflex Sympathetic Dystrophy

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Author Info

  • Hiske E.M. van Dieten

    (Department of Clinical Epidemiology and Biostatistics, Vrije Universiteit, Amsterdam, Netherlands)

  • Roberto S.G.M. Perez

    (Department of Anesthesiology, Vrije Universiteit Medisch Centrum, Amsterdam, Netherlands)

  • Maurits W. van Tulder

    (Department of Clinical Epidemiology and Biostatistics, Vrije Universiteit, Amsterdam, Netherlands)

  • Jaap J. de Lange

    (Department of Anesthesiology, Vrije Universiteit Medisch Centrum, Amsterdam, Netherlands)

  • Wouter W.A. Zuurmond

    (Department of Anesthesiology, Vrije Universiteit Medisch Centrum, Amsterdam, Netherlands)

  • Herman J. Ader

    (Department of Clinical Epidemiology and Biostatistics, Vrije Universiteit, Amsterdam, Netherlands)

  • Hindrik Vondeling

    (Department of Health Economics, University of Southern Denmark, Odense, Denmark)

  • Maarten Boers

    (Department of Clinical Epidemiology and Biostatistics, Vrije Universiteit, Amsterdam, Netherlands)

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    Abstract

    Objective: To determine the cost effectiveness and cost utility of acetylcysteine versus dimethyl sulfoxide (DMSO) for patients with reflex sympathetic dystrophy (RSD), from a societal viewpoint. Design: An economic evaluation was conducted alongside a double-dummy, double-blind, randomised, controlled trial. Patients were followed for 1 year. The primary outcome measure was the Impairment-level Sum Score (ISS). Utilities were determined by the EuroQOL instrument (EQ-5D). Both cost-effectiveness and cost-utility analyses were performed. Differences in mean direct, indirect and total costs were estimated. Corresponding 95% confidence intervals were calculated by bootstrapping techniques. Results: Both groups (DMSO, n = 64; acetylcysteine, n = 67) showed relevant improvement; no differences in effects were found. Only the total direct costs were significantly lower in the DMSO group for the period of 0-52 weeks. The incremental cost-effectiveness ratios showed that, in general, DMSO generated fewer costs and more effects compared with acetylcysteine. Post-hoc subgroup analyses on cost effectiveness suggested that patients with warm RSD could be best treated with DMSO and patients with cold RSD with acetylcysteine. These results were based on small subsamples. Conclusion: In general, DMSO is the preferred treatment for patients with RSD.

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    Bibliographic Info

    Article provided by Springer Healthcare | Adis in its journal PharmacoEconomics.

    Volume (Year): 21 (2003)
    Issue (Month): 2 ()
    Pages: 139-148
    Download reference. The following formats are available: HTML (with abstract), plain text (with abstract), BibTeX, RIS (EndNote, RefMan, ProCite), ReDIF
    Handle: RePEc:wkh:phecon:v:21:y:2003:i:2:p:139-148

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    For corrections or technical questions regarding this item, or to correct its listing, contact: (Dave Dustin).

    Related research

    Keywords: Acetylcysteine; Cost analysis; Cost utility; Dimethyl sulfoxide; Pharmacoeconomics; Reflex sympathetic dystrophy;

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