Treatment cost effectiveness in acute otitis media: A watch-and-wait approach versus amoxicillin
Isabelle Gaboury1, Kathryn Coyle, Douglas Coyle
1Children's Hospital of Eastern Ontario Research Institute;
Insights
Amoxicillin treatment for acute otitis media in children may be more cost-effective than a watch-and-wait approach. This study compared costs for pediatric patients in Canada, finding amoxicillin treatment potentially offers better value.
Area of Science:
- Pediatric Health
- Pharmacoeconomics
- Infectious Disease Management
Background:
- Acute otitis media (AOM) is a common childhood illness.
- Antimicrobial therapy is the standard treatment for AOM in Canada.
- The economic implications of different AOM treatment strategies require evaluation.
Purpose of the Study:
- To compare the cost-effectiveness of amoxicillin versus a watch-and-wait (WAIT) approach for pediatric AOM in Canada.
- To analyze direct medical and patient costs associated with each treatment strategy.
Main Methods:
- A randomized controlled trial involving 488 children aged 6 months to 5 years.
- Cost analysis comparing medication, healthcare, and patient expenses for amoxicillin and WAIT groups.
- Evaluation within a Canadian healthcare setting.
Main Results:
- Average medication costs were higher for amoxicillin ($17.26) than WAIT ($4.33).
- Total healthcare and patient costs were greater for the WAIT group ($162.48 + $31.87) compared to amoxicillin ($148.44 + $23.50).
- Mean total treatment cost was lower for amoxicillin ($189.20) versus WAIT ($198.68).
Conclusions:
- Amoxicillin treatment may be a cost-effective strategy for pediatric acute otitis media in Canada.
- The study did not assess the impact of antimicrobial resistance.
- Further economic evaluations considering long-term outcomes and resistance are warranted.
Abstract:
In Canada, antimicrobial treatment is the most common approach for acute otitis media. The aim of the present study was to compare the cost effectiveness of treatment with amoxicillin versus a watch-and-wait approach (WAIT) within a Canadian pediatric setting. Four hundred eighty-eight children, six months to five years of age, who participated in a randomized controlled trial were included in the study. The average medication costs per patient were higher for the amoxicillin group ($17.26) than for the WAIT group ($4.33). However, both health care ($148.44 versus $162.48) and patient costs ($23.50 versus $31.87) were greater for the WAIT group. The mean cost of treatment for the amoxicillin group was $189.20, compared with $198.68 for the WAIT group. Amoxicillin may be cost effective in treating children with acute otitis media. The potential development of antimicrobial resistance was not addressed in the present study.
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