A cost effectiveness analysis of the preferred antidotes for acute paracetamol poisoning patients in Sri Lanka.

BMC Clinical Pharmacology
S M D K Ganga SenarathnaRohini Fernandopulle

Abstract

Acute paracetamol poisoning is a rapidly increasing problem in Sri Lanka. The antidotes are expensive and yet no health economic evaluation has been done on the therapy for acute paracetamol poisoning in the developing world. The aim of this study is to determine the cost effectiveness of using N-acetylcysteine over methionine in the management of acute paracetamol poisoning in Sri Lanka. Economic analysis was applied using public healthcare system payer perspective. Costs were obtained from a series of patients admitted to the National Hospital of Sri Lanka with a history of acute paracetamol overdose. Evidence on effectiveness was obtained from a systematic review of the literature. Death due to hepatotoxicity was used as the primary outcome of interest. Analysis and development of decision tree models was done using Tree Age Pro 2008. An affordable treatment threshold of Sri Lankan rupees 1,537,120/death prevented was set from the expected years of productive life gained and the average contribution to GDP. A cost-minimisation analysis was appropriate for patients presenting within 10 hours and methionine was the least costly antidote. For patients presenting 10-24 hours after poisoning, n-acetylcysteine was more effective a...Continue Reading

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Citations

Oct 2, 2012·BMC Pharmacology & Toxicology·Abd-Rahman MarzilawatiSanjiv Mahadeva
Aug 24, 2013·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·S B Duffull, G K Isbister
Nov 14, 2013·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Geoffrey K Isbister, Stephen Brent Duffull
Jun 16, 2017·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Anselm WongAndrew Stolbach
Feb 24, 2018·The Cochrane Database of Systematic Reviews·Angela L ChiewNick A Buckley
Sep 16, 2017·Crisis·Lizell Bustamante MadsenFlemming Konradsen
Aug 16, 2017·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Anselm WongAndis Graudins

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