Janeczek Kamil, Bodajko-Grochowska Anna, Emeryk Andrzej, Czerwiñska-Pawluk Iwona
Department of Pulmonary Diseases and Children Rheumatology, Medical University of Lublin, Lublin, Poland.
Pulmonary Function Testing Laboratory, Children's University Hospital, Lublin, Poland.
Postepy Dermatol Alergol. 2021 Dec;38(6):1011-1016. doi: 10.5114/ada.2020.98131. Epub 2020 Sep 9.
Recommended methods of administering bronchodilator drugs in children with asthma exacerbations in a hospital include the pressurized metered-dose inhaler (pMDI) and nebulization (NEB). These methods differ in clinical effectiveness, safety and, as some studies indicate, the cost of their use in a child.
To calculate the direct costs of hospital therapy conducted with the use of short-acting β-agonist (SABA) or its combination with short-acting muscarinic antagonist (SAMA) administered via pMDI with valved holding chamber (VHC) versus the same drugs in NEB in children with asthma exacerbation.
A retrospective analysis of the costs of SABA (salbutamol) and SABA + SAMA (fenoterol + ipratropium bromide) inhalation therapy was performed. Based on the data obtained from the financial department, the pharmacy, and the sterilization department of the university hospital, the direct unit cost of the inhalation therapy in the child was calculated.
The results of the analysis indicate that in a hospital setting the cost of one-time SABA or SABA + SAMA administration via pMDI+VHC is 1.5-2.4 times lower compared to NEB. The payer incurred the lowest costs during anti-obstructive treatment using SABA with pMDI + VHC (PLN 9.39 for one inhalation procedure). The working time of medical staff during the inhalation treatment is the component generating the highest cost for the hospital (up to 40% of direct costs).
In hospital conditions, the supply of SABA or SABA + SAMA with the use of pMDI + VHC in a child with asthma exacerbation is more beneficial financially than the supply of the same drugs in NEB.
在医院中，推荐用于治疗哮喘急性发作儿童的支气管扩张剂给药方法包括压力定量吸入器（pMDI）和雾化吸入（NEB）。这些方法在临床疗效、安全性方面存在差异，并且正如一些研究表明的那样，在儿童中使用它们的成本也有所不同。
计算在哮喘急性发作儿童中，使用带储雾罐（VHC）的pMDI吸入短效β受体激动剂（SABA）或其与短效毒蕈碱拮抗剂（SAMA）联合用药与使用相同药物进行雾化吸入治疗的直接成本。
对SABA（沙丁胺醇）和SABA + SAMA（非诺特罗+异丙托溴铵）吸入治疗的成本进行回顾性分析。根据从大学医院财务部门、药房和消毒部门获得的数据，计算儿童吸入治疗的直接单位成本。
分析结果表明，在医院环境中，通过pMDI + VHC一次性给予SABA或SABA + SAMA的成本比雾化吸入低1.5至2.4倍。在使用SABA和pMDI + VHC进行抗阻塞治疗期间，支付方产生的成本最低（一次吸入治疗为9.39波兰兹罗提）。吸入治疗期间医务人员的工作时间是医院产生最高成本的组成部分（高达直接成本的40%）。
在医院环境中，如果哮喘急性发作儿童使用pMDI + VHC吸入SABA或SABA + SAMA，在经济上比使用相同药物进行雾化吸入更有益。
