The cost-effectiveness of the management of acute sinusitis.
BACKGROUND
Sinusitis is a common medical disease with a tremendous economic impact on health care. Our objective was to determine the most cost-effective strategy for the management of acute sinusitis from the societal and payers' perspectives.


METHODS
A Markov disease simulation model was used for comparing four treatment strategies: (1) no antibiotic (Abx), (2) empiric Abx, (3) CT-based Abx, and (4) clinical guideline-based Abx.


RESULTS
Empiric Abx treatment was the most cost-effective from the societal perspective. Clinical guideline-based treatment was the most cost-effective strategy from the payers' perspective ($38,515/quality-adjusted life year). Cost and effectiveness of Abx, time lost from work, and prevalence of acute bacterial sinusitis are influential variables.


CONCLUSIONS
Empiric Abx treatment is a cost-effective strategy from the short-term societal perspective. However, Abx resistance will lead to increased costs and reduced efficacy of this strategy in the long-term. Clinical guidelines provide a low-cost method of targeting therapy.
Anzai
Yoshimi
Y
Department of Radiology, University of Washington, Seattle 98195-7115, USA. anzai@u.washington.edu
Jarvik
Jeffrey G
JG
Sullivan
Sean D
SD
Hollingworth
William
W
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use; D003198:Computer Simulation; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D017048:Health Care Costs; D006801:Humans; D008390:Markov Chains; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012852:Sinusitis / Q000188:drug therapy* / Q000191:economics*; D014481:United States
D000900:Anti-Bacterial Agents