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Cost-utility analysis of topical intranasal steroids for otitis media with effusion based on evidence from the GNOME trial

Record type: Article

Methods
An economic evaluation was conducted based on evidence from the double-blind, randomized, placebo-controlled GPRF [General Practice Research Framework] Nasal Steroids for Otitis Media with Effusion (GNOME) trial. Participants comprised 217 children aged 4–11 years who had at least one episode of otitis media or related ear problem in the previous 12 months and had tympanometrically confirmed bilateral OME. Children were randomly allocated to receive either mometasone furoate 50 µg or placebo spray once daily into each nostril for 3 months. The main outcome measure was the incremental cost per quality-adjusted life-year (QALY) gained for topical steroids compared with placebo. The nonparametric bootstrap method was used to present cost-effectiveness acceptability curves at alternative willingness to pay thresholds.

Results
Children receiving topical steroids accrued nonsignificantly higher costs (incremental cost/child: £11, 95% confidence interval [CI]: ?£199 to £222) and nonsignificantly fewer QALYs (incremental QALY gain/child: ?0.0166, 95% CI: ?0.0652 to 0.0320) than those receiving placebo. Topical steroids had a 24.19% probability of being cost-effective at a £20,000 per QALY gained threshold, a 23.82% probability of being more effective and a 46.25% probability of being less costly. Sensitivity and subgroup analyses showed incremental costs and benefits to be highly sensitive to the methods used and the patient group considered, although differences between groups did not reach statistical significance in any analysis.

Conclusions
Topical steroids are unlikely to be a cost-effective treatment for OME in general practice.

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Citation

Petrou, S., Dakin, H., Abangma, G., Benge, S. and Williamson, I. (2010) Cost-utility analysis of topical intranasal steroids for otitis media with effusion based on evidence from the GNOME trial Value in Health, 13, (15), pp. 543-551. (doi:10.1111/j.1524-4733.2010.00711.x). (PMID:20345546).

More information

e-pub ahead of print date: 22 March 2010
Published date: July 2010
Keywords: cost-effectiveness, cost-utility analysis, otitis media with effusion, randomized controlled trial
Organisations: Community Clinical Sciences

Identifiers

Local EPrints ID: 73279
URI: http://eprints.soton.ac.uk/id/eprint/73279
ISSN: 1098-3015
PURE UUID: e1206a47-c269-4766-b74f-bbb96c3a53eb

Catalogue record

Date deposited: 04 Mar 2010
Last modified: 18 Jul 2017 23:50

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Contributors

Author: S. Petrou
Author: H. Dakin
Author: G. Abangma
Author: S. Benge
Author: I. Williamson

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