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The cost-effectiveness of the management of acute sinusitis
Yoshimi Anzai1, Jeffrey G Jarvik, Sean D Sullivan
1Department of Radiology, University of Washington, Seattle 98195-7115, USA. anzai@u.washington.edu
Background:
Sinusitis is a common medical disease with a tremendous economic impact on health care. Our objective was to determine the most cost-effective strategy for the management of acute sinusitis from the societal and payers' perspectives.
Methods:
A Markov disease simulation model was used for comparing four treatment strategies: (1) no antibiotic (Abx), (2) empiric Abx, (3) CT-based Abx, and (4) clinical guideline-based Abx.
Results:
Empiric Abx treatment was the most cost-effective from the societal perspective. Clinical guideline-based treatment was the most cost-effective strategy from the payers' perspective ($38,515/quality-adjusted life year). Cost and effectiveness of Abx, time lost from work, and prevalence of acute bacterial sinusitis are influential variables.
Conclusion:
Empiric Abx treatment is a cost-effective strategy from the short-term societal perspective. However, Abx resistance will lead to increased costs and reduced efficacy of this strategy in the long-term. Clinical guidelines provide a low-cost method of targeting therapy.
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