@article{Burns:2018:10.1136/bmjopen-2017-019184,
author = {Burns, RM and Wolstenholme, J and Jawad, S and Williams, N and Thompson, M and Perera, R and Hay, AD and Heneghan, C and Little, P and Moore, M and Hayward, G},
doi = {10.1136/bmjopen-2017-019184},
journal = {BMJ OPEN},
title = {Economic analysis of oral dexamethasone for symptom relief of sore throat: the UK TOAST study},
url = {http://dx.doi.org/10.1136/bmjopen-2017-019184},
volume = {8},
year = {2018}
}

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TY  - JOUR
AB  - Objectives To undertake an economic analysis assessing the cost-effectiveness of a single dose of oral dexamethasone compared with placebo for the relief of sore throat.Design A UK-based, multicentre, two arm, individually randomised, double blind trial.Setting and population Adults (≥18 years) with acute sore throat and painful swallowing judged to be infective in origin, recruited and randomised in primary care. Intervention: a single dose of 10 mg oral dexamethasone compared with placebo given at primary care visit.Main outcome Incremental cost-effectiveness ratios (ICERs), cost per quality-adjusted symptom resolution using the EuroQol-five dimensions-five levels instrument, were estimated as part of a cost–utility analysis performed on an intention-to-treat cohort adopting a health payers perspective.Results Differences in health-related quality of life (HRQoL) over 7 days from baseline and at 24 hours in the dexamethasone compared with the placebo group (2.9% and 2.5% higher, respectively) were observed. After controlling for the baseline HRQoL imbalances, the economic impact of the intervention was not statistically significant: the quality-adjusted life year difference was −0.00005 (95% CI −0.0002 to 0.00011) equivalent to a loss in HRQoL of a half hour in the dexamethasone group. The average cost per patient associated in the dexamethasone and placebo groups in the basecase analysis was £73 and £69, respectively. In the basecase probabilistic analysis, the mean ICER was −£6440 (95% CI −£132 151 to £126 335) and the median ICER was −£304 (IQR-£5816 to £3877); suggesting considerable uncertainty.Conclusions and relevance The economic burden associated with sore throat is substantial and was estimated at £2.35 billion to the healthcare services payer based on reported resource use and 2015 UK unit costs. There is considerable uncertainty regarding the cost
AU  - Burns,RM
AU  - Wolstenholme,J
AU  - Jawad,S
AU  - Williams,N
AU  - Thompson,M
AU  - Perera,R
AU  - Hay,AD
AU  - Heneghan,C
AU  - Little,P
AU  - Moore,M
AU  - Hayward,G
DO  - 10.1136/bmjopen-2017-019184
PY  - 2018///
SN  - 2044-6055
TI  - Economic analysis of oral dexamethasone for symptom relief of sore throat: the UK TOAST study
T2  - BMJ OPEN
UR  - http://dx.doi.org/10.1136/bmjopen-2017-019184
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000435176700046&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/62266
VL  - 8
ER  - 

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