Cost-effectiveness of intrapleural use of tissue plasminogen activator and DNase in pleural infection: Evidence from the MIST2 randomised controlled trial.
The MIST2 trial showed that combined intrapleural use of tissue plasminogen activator (t-PA) and DNase was effective when compared to single agents or placebo. However, the treatment costs are significant and overall cost-effectiveness of combined therapy remains unclear.An economic evaluation of th...
| Hauptverfasser: | , , , , , , |
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| Format: | Journal article |
| Sprache: | English |
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European Respiratory Society Publications
2019
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| _version_ | 1826290016915030016 |
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| author | Luengo-Fernandez, R Penz, E Dobson, M Psallidas, I Nunn, A Maskell, N Rahman, N |
| author_facet | Luengo-Fernandez, R Penz, E Dobson, M Psallidas, I Nunn, A Maskell, N Rahman, N |
| author_sort | Luengo-Fernandez, R |
| collection | OXFORD |
| description | The MIST2 trial showed that combined intrapleural use of tissue plasminogen activator (t-PA) and DNase was effective when compared to single agents or placebo. However, the treatment costs are significant and overall cost-effectiveness of combined therapy remains unclear.An economic evaluation of the MIST2 trial was performed to assess the cost-effectiveness of combined therapy. Costs included were those related to study medications, initial hospital stay, and subsequent hospitalisations. Outcomes were measured in terms of life-years gained. All costs were reported in Euros (€) and in 2016 prices.Mean annual costs were lowest in the tPA-DNase group (€10 605 for t-PA, €17 856 for DNase; €13 483 for placebo, €7248 for t-PA-DNase (p=0.209)). Mean 1-year life expectancy was: 0.988 for t-PA; 0.923 for DNase; and 0.969 for both placebo and t-PA-DNase (p=0.296). Both DNase and placebo were less effective, in terms of life-years gained, and more costly than t-PA. When t-PA-DNase was compared to placebo, the incremental cost per life-year gained of t-PA-DNase was €1.6 billion, with a probability of 0.85 of t-PA-DNase being cost-effective.This study demonstrates that combined t-PA-DNase is likely to be highly cost-effective. In light of this evidence, a definitive trial designed to facilitate a thorough economic evaluation is warranted to provide further evidence on cost-effectiveness of this promising combined intervention. |
| first_indexed | 2024-03-07T02:37:44Z |
| format | Journal article |
| id | oxford-uuid:a959ef24-0ec4-45c6-99d5-885d7af6eef5 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T02:37:44Z |
| publishDate | 2019 |
| publisher | European Respiratory Society Publications |
| record_format | dspace |
| spelling | oxford-uuid:a959ef24-0ec4-45c6-99d5-885d7af6eef52022-03-27T03:08:01ZCost-effectiveness of intrapleural use of tissue plasminogen activator and DNase in pleural infection: Evidence from the MIST2 randomised controlled trial.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a959ef24-0ec4-45c6-99d5-885d7af6eef5EnglishSymplectic Elements at OxfordEuropean Respiratory Society Publications2019Luengo-Fernandez, RPenz, EDobson, MPsallidas, INunn, AMaskell, NRahman, NThe MIST2 trial showed that combined intrapleural use of tissue plasminogen activator (t-PA) and DNase was effective when compared to single agents or placebo. However, the treatment costs are significant and overall cost-effectiveness of combined therapy remains unclear.An economic evaluation of the MIST2 trial was performed to assess the cost-effectiveness of combined therapy. Costs included were those related to study medications, initial hospital stay, and subsequent hospitalisations. Outcomes were measured in terms of life-years gained. All costs were reported in Euros (€) and in 2016 prices.Mean annual costs were lowest in the tPA-DNase group (€10 605 for t-PA, €17 856 for DNase; €13 483 for placebo, €7248 for t-PA-DNase (p=0.209)). Mean 1-year life expectancy was: 0.988 for t-PA; 0.923 for DNase; and 0.969 for both placebo and t-PA-DNase (p=0.296). Both DNase and placebo were less effective, in terms of life-years gained, and more costly than t-PA. When t-PA-DNase was compared to placebo, the incremental cost per life-year gained of t-PA-DNase was €1.6 billion, with a probability of 0.85 of t-PA-DNase being cost-effective.This study demonstrates that combined t-PA-DNase is likely to be highly cost-effective. In light of this evidence, a definitive trial designed to facilitate a thorough economic evaluation is warranted to provide further evidence on cost-effectiveness of this promising combined intervention. |
| spellingShingle | Luengo-Fernandez, R Penz, E Dobson, M Psallidas, I Nunn, A Maskell, N Rahman, N Cost-effectiveness of intrapleural use of tissue plasminogen activator and DNase in pleural infection: Evidence from the MIST2 randomised controlled trial. |
| title | Cost-effectiveness of intrapleural use of tissue plasminogen activator and DNase in pleural infection: Evidence from the MIST2 randomised controlled trial. |
| title_full | Cost-effectiveness of intrapleural use of tissue plasminogen activator and DNase in pleural infection: Evidence from the MIST2 randomised controlled trial. |
| title_fullStr | Cost-effectiveness of intrapleural use of tissue plasminogen activator and DNase in pleural infection: Evidence from the MIST2 randomised controlled trial. |
| title_full_unstemmed | Cost-effectiveness of intrapleural use of tissue plasminogen activator and DNase in pleural infection: Evidence from the MIST2 randomised controlled trial. |
| title_short | Cost-effectiveness of intrapleural use of tissue plasminogen activator and DNase in pleural infection: Evidence from the MIST2 randomised controlled trial. |
| title_sort | cost effectiveness of intrapleural use of tissue plasminogen activator and dnase in pleural infection evidence from the mist2 randomised controlled trial |
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