Pneumatic dilation versus intrasphincteric botulinum toxin injection in the treatment of achalasia cardia in India: an economic analysis.

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dc.contributor.authorGhoshal, U Cen_US
dc.contributor.authorAggarwal, Ren_US
dc.contributor.authorKumar, Sen_US
dc.contributor.authorNaik, S Ren_US
dc.date.accessioned2002-09-06en_US
dc.date.accessioned2009-05-29T02:20:07Z
dc.date.available2002-09-06en_US
dc.date.available2009-05-29T02:20:07Z
dc.date.issued2002-09-06en_US
dc.description.abstractBACKGROUND: Pneumatic dilation (PD) is an established therapeutic option for achalasia cardia. Recently, intrasphincteric botulinum toxin (BT) has been used to treat achalasia cardia in view of its simplicity and safety. However, it is likely to be a costly treatment as repeated injections are often needed due to its short-lasting effect. No economic analysis of PD and BT strategies has been done in India. METHODS: A decision tree was constructed using decision analysis software (DATA 4.0; TreeAge Software, Williamstown, MA, USA). Probability estimates for BT injection and PD (and, in case of failure, surgery) were obtained from published literature, preferably from India. Direct "out-of-pocket" costs (in Indian rupees; currently US$ 1 = 49 rupees approximately) for baseline analysis were obtained from our hospital and from some private hospitals. Sensitivity analysis was done using a wide range of probability and cost estimates. RESULTS: Intrasphincteric BT injection strategy was more costly at 18,520 rupees per patient than PD strategy (4,568 rupees), yielding an incremental cost of 13,952 rupees per patient successfully treated. Sensitivity analysis supported the conclusions of the baseline analysis. CONCLUSION: Primary intrasphincteric BT injection strategy was costlier than primary PD strategy in the treatment of achalasia cardia in India, and therefore cannot be justified despite its efficacy, relative ease of administration and safety.en_US
dc.description.affiliationDepartment of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow. ghoshal@sgpgi.ac.inen_US
dc.identifier.citationGhoshal UC, Aggarwal R, Kumar S, Naik SR. Pneumatic dilation versus intrasphincteric botulinum toxin injection in the treatment of achalasia cardia in India: an economic analysis. Indian Journal of Gastroenterology. 2002 Sep-Oct; 21(5): 193-6en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/64016
dc.language.isoengen_US
dc.source.urihttps://www.indianjgastro.comen_US
dc.subject.meshAgeden_US
dc.subject.meshBotulinum Toxin Type A --economicsen_US
dc.subject.meshCost-Benefit Analysis --economicsen_US
dc.subject.meshDecision Treesen_US
dc.subject.meshDilatation --methodsen_US
dc.subject.meshEsophageal Achalasia --economicsen_US
dc.subject.meshEsophagogastric Junction --drug effectsen_US
dc.subject.meshHumansen_US
dc.subject.meshIndiaen_US
dc.subject.meshInjectionsen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNeuromuscular Agents --economicsen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshTreatment Outcomeen_US
dc.titlePneumatic dilation versus intrasphincteric botulinum toxin injection in the treatment of achalasia cardia in India: an economic analysis.en_US
dc.typeComparative Studyen_US
dc.typeJournal Articleen_US
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