title: [Cost effectiveness of the application of inhaled ipratropium bromide in the treatment of adult patients with acute asthma in Uruguay].
abstract: BACKGROUND
  Administration of multiple doses of inhaled impratropium bromide and salbutamol represents the first-choice treatment for severe asthmatic crisis. However, there is a scarce evidence demonstrating that this therapeutic intervention in cost-effective.
  
  
  OBJECTIVE
  To determine cost-effectiveness relationship related to administration of ipratropium bromide in the treatment of severe asthmatic crisis in adults at two hospitals in Montevideo, Uruguay.
  
  
  METHODS
  The cost of each treatment was estimated in U$S 0.9 when drug was administered by a metered dose pressurized inhaler (MDI) or U$S 1.7 by using a jet nebulizer (NEB).
  
  
  RESULTS
  A monetary saving per patient (considering a median of five days of hospitalization and a risk reduction of 0.17) of U$S 30 with MDI or U$S 29 with NEB was observed in the public practice, and a saving of U$S 78 and 77, respectively in the private practice. The total annual monetary saving was of U$S 3,101 with MDI and U$S 2,897 with NEB in the public practice, and of U$S 4,979 and U$S 4,830 in the private practice. A two-way sensitivity analysis taking into account the length of hospitalizations and the risk reduction did not modify significantly the results.
  
  
  CONCLUSIONS
  The treatment of adults with severe acute asthma by using ipratropium bromide results cost-effective, leading to a significant saving of resources.
authors.affiliation: Departamento de emergencia, Hospital Central de las Fuerzas Armadas, Av. 8 de Octubre 3020, Montevideo 11600, Uruguay.
authors.forename: Gustavo J
authors.initials: GJ
authors.lastname: Rodrigo
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodrigo
mesh_terms: D000208:Acute Disease; D000280:Administration, Inhalation; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006772:Hospitals, Military / Q000191:economics; D006786:Hospitals, Urban / Q000191:economics; D006788:Hospitals, Voluntary / Q000191:economics; D006801:Humans; D009241:Ipratropium / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D007902:Length of Stay / Q000191:economics; D040242:Risk Reduction Behavior; D014583:Uruguay
chemical_list: D018927:Anti-Asthmatic Agents; D009241:Ipratropium