title: Effects of recombinant human DNase therapy on healthcare use and costs in patients with cystic fibrosis.
abstract: OBJECTIVE
  To assess the effects of recombinant human DNase (rhDNase) therapy on the cost of treating respiratory tract infections (RTIs) in patients with cystic fibrosis.
  
  
  METHODS
  We prospectively documented the use of healthcare services among 968 patients with cystic fibrosis who participated in a recent Phase III double-blind, multicenter, clinical trial in which patients were assigned randomly to receive either rhDNase 2.5 mg once daily, rhDNase 2.5 mg twice daily, or placebo. All patients were followed for 24 weeks. Data from secondary sources were used to estimate a total cost of RTI-related care (excluding the cost of study therapy) for each trial participant, based on observed levels of resource use.
  
  
  METHODS
  Number of RTI-related hospital admissions, days of RTI-related outpatient antibiotic therapy (intravenous and oral), and total costs of RTI-related care (excluding the cost of study therapy).
  
  
  RESULTS
  Patients randomized to receive rhDNase once daily averaged 0.15 fewer RTI-related hospital admissions (0.41 vs 0.56 for placebo; p < 0.05) and 1.5 fewer days of RTI-related outpatient intravenous antibiotic therapy (2.9 vs 4.4; p < 0.05). Patients randomized to receive rhDNase twice daily had 0.14 fewer hospital admissions (p < 0.01), but no reduction in outpatient intravenous antibiotic therapy. Compared with placebo, the cost of treating RTIs over 24 weeks was $814-1682 less among patients receiving rhDNase.
  
  
  CONCLUSIONS
  rhDNase therapy reduced the costs of treating RTIs in patients with cystic fibrosis; assuming once-daily dosing, these savings would offset about one-third of the cost of such therapy.
authors.affiliation: Genentech, South San Francisco, CA, USA.
authors.forename: G
authors.initials: G
authors.lastname: Oster
authors.forename: D M
authors.initials: DM
authors.lastname: Huse
authors.forename: M J
authors.initials: MJ
authors.lastname: Lacey
authors.forename: M M
authors.initials: MM
authors.lastname: Regan
authors.forename: H J
authors.initials: HJ
authors.lastname: Fuchs
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000191:economics; D003850:Deoxyribonuclease I / Q000627:therapeutic use*; D004311:Double-Blind Method; D005100:Expectorants / Q000627:therapeutic use; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000191:economics; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005100:Expectorants; D011994:Recombinant Proteins; C085693:DNASE1 protein, human; D003850:Deoxyribonuclease I