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EFFECTIVENESS AND COST-BENEFIT ANALYSIS OF LEUKOTRIENE MODIFIERS IN PATIENTS WITH ASTHMA IN THE OHIO MEDICAID POPULATION

HEATON, PAMELA CHRISTINE
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1061230182

Abstract Details

2003, PhD, University of Cincinnati, Pharmacy : Pharmaceutical Sciences.
Objectives: To determine the impact of leukotriene modifiers on subsequent emergency room visits, hospitalizations and steroid bursts; and to estimate whether leukotriene modifier use is cost-effective. Methods: This study was a retrospective, longitudinal study of asthmatic patients in the fee-for-service Ohio Medicaid program. The study population included 11,533 adult patients and 18,563 pediatric patients who had an asthma diagnosis during 2001. The rate of adverse outcomes and logistic regression was used to determine the impact of leukotriene modifier use on three outcome measures: emergency room visits, hospitalizations, or steroid bursts. Propensity scores were used to control for the selection bias inherent in drug treatment selection. A cost-benefit analysis was also calculated. Results: In the adults, leukotriene modifier users had 16.4 events per one hundred patients versus the nonusers who had 10.3 events per one hundred patients, a difference of 6.1. This suggests that for every 15 adults treated, one will have an adverse outcome (Number needed to harm=1/0.061). In the children, leukotriene modifier users had 18.5 events per one hundred patients versus the nonusers who had 6.5 events per one hundred patients, a difference of 12. This suggests that for every 8.3 children treated, one will have an adverse outcome (Number needed to harm=1/0.12). In the logistic regression models, the use of leukotriene modifiers did not have a significant effect, positive or negative, on any of the outcome variables in adults. In children, however, there was a significant increased risk for requiring an emergency room visit (OR 1.0014, 95% CI 1.0002-1.0027) or a steroid burst (OR 1.0017, 95% CI 1.0001-1.0033). In both the adult and pediatric population, the cost benefit analysis shows that there was a total net loss to Ohio Medicaid. Conclusions: The results suggest that adult leukotriene modifier users do not have fewer adverse outcomes than nonusers and pediatric leukotriene modifier users have more adverse outcomes when compared to nonusers. The use of leukotriene modifiers resulted in a net loss to Ohio Medicaid.
Dr. Jeff Guo (Advisor)
189 p.
leukotriene modifiers; asthma; propensity score; retrospective database analysis

Recommended Citations

Citations

  • HEATON, P. C. (2003). EFFECTIVENESS AND COST-BENEFIT ANALYSIS OF LEUKOTRIENE MODIFIERS IN PATIENTS WITH ASTHMA IN THE OHIO MEDICAID POPULATION [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1061230182

    APA Style (7th edition)

  • HEATON, PAMELA. EFFECTIVENESS AND COST-BENEFIT ANALYSIS OF LEUKOTRIENE MODIFIERS IN PATIENTS WITH ASTHMA IN THE OHIO MEDICAID POPULATION. 2003. University of Cincinnati, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1061230182.

    MLA Style (8th edition)

  • HEATON, PAMELA. "EFFECTIVENESS AND COST-BENEFIT ANALYSIS OF LEUKOTRIENE MODIFIERS IN PATIENTS WITH ASTHMA IN THE OHIO MEDICAID POPULATION." Doctoral dissertation, University of Cincinnati, 2003. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1061230182

    Chicago Manual of Style (17th edition)

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© 2003, all rights reserved.
This open access ETD is published by University of Cincinnati and OhioLINK.