Cost-effectiveness of hydroxyurea in reducing the frequency of pain episodes and hospitalization in pediatric sickle cell disease

American Journal of Hematology
James R StallworthAvnish Tripathi

Abstract

In a cohort of children with sickle cell disease (SCD) and vaso-occlusive pain visits served through South Carolina's Medicaid system over a 6-year period (N 5 523), we compared the number of vaso-occlusive pain or acute chest syndrome (ACS)/pneumonia episodes, and outpatient or acute service costs in those treated or not treated with hydroxyurea (HU). HU may be an underused intervention for SCD in this practice setting, for a variety of reasons. Treatment with HU varied greatly, appears to have been administered to more severely ill children, but was associated with a reduction in vaso-occlusive pain episodes, hospitalizations,and total costs of care within the HU cohort during a 2-3 year period of active HU treatment. Those receiving care through specialized SCD clinics were less likely to have pain or acute care episodes(RR 5 0.79, P < 0.0001; RR 5 0.90, P 5 0.01). Compared with the non-HU cohort, the HU group evinced a significantly higher risk of experiencing vaso-occlusive pain episodes (RR 5 3.32, P < 0.0001)and ACS/pneumonia episodes (RR 5 2.66, P < 0.0001), and higher outpatient,inpatient/emergency, and total service costs (RR 5 1.85, 2.11,2.10, and P < 0.0001, respectively) over time. HU is clinically effective in red...Continue Reading

Citations

Feb 24, 2012·Current Opinion in Hematology·Pablo Bartolucci, Frédéric Galactéros
Apr 26, 2011·Journal of Pediatric Hematology/oncology·Courtney D ThornburgJulie A Panepinto
Oct 7, 2011·The Primary Care Companion to CNS Disorders·Jeanette M JerrellRoger S McIntyre
Jan 10, 2012·Pediatric Blood & Cancer·Jean L RaphaelSuzette O Oyeku
May 18, 2011·Pediatric Blood & Cancer·Jean L RaphaelThomas Giordano
Mar 18, 2015·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Angela M EllisonElizabeth R Alpern
Sep 3, 2013·Archives of Disease in Childhood·Mercy MulakuMike English
Oct 8, 2014·Blood·Trisha E WongRichard Lottenberg
Oct 6, 2010·Pediatric Blood & Cancer·Avnish TripathiJames R Stallworth
May 23, 2019·Clinical Pediatrics·Sarah L ReevesKevin J Dombkowski
May 23, 2020·JMIR Research Protocols·Jane S HankinsUNKNOWN Sickle Cell Disease Implementation Consortium

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