title: Cost-effective analysis of topical chlorhexidine in hematologic patients at risk for oral mucositis.
abstract: OBJECTIVE
  The aim of this study was to explore whether management of mucositis with Chlorhexidine (CHX) mouthwash could be a cost-effective method to decrease the risk of mortality and economic burden in hemato-oncologic or hematopoietic stem cell transplantation (HSCT) patients.
  
  
  METHODS
  A cost-effectiveness analysis model of prophylactic CHX mouthwash use versus no-CHX mouthwash use for the prevention of oral mucositis was developed for patients undergoing cytotoxic therapy or HSCT. The outcome variable was survival. The primary variables were CHX mouthwash use, probability of mucositis, probability of increased hospital stay, and length of hospital stay. Probability and cost data were obtained from the literature.
  
  
  RESULTS
  Our analysis selected CHX mouthwash use during anticancer treatment as the preferred strategy for the base-case analysis as compared to no CHX mouthwash (marginal value 0.032). There was a $14,391 cost difference per patient between the two strategies.
  
  
  CONCLUSIONS
  The results of this study suggest that CHX mouthwash use during anticancer treatment results in an increased survival and decreased cost for the population studied. Using our base-case data, an additional 32 of every 1,000 hemato-oncologic or HSCT patients will survive when employing the preferred strategy of prophylactic CHX mouthwash.
  
  
  CONCLUSIONS
  CHX mouthwash should be offered for hematologic patients undergoing HSCT or administered with chemotherapy.
authors.affiliation: Division of Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave., Rochester, 14620, NY, USA. selad@URMC.Rochester.edu.|Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA. selad@URMC.Rochester.edu.
authors.forename: Sharon
authors.initials: S
authors.lastname: Elad
authors.affiliation: School of Dentistry, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Todd
authors.initials: T
authors.lastname: Thierer
mesh_terms: D000287:Administration, Topical; D000328:Adult; D002710:Chlorhexidine / Q000008:administration & dosage / Q000191:economics; D003365:Costs and Cost Analysis; D018572:Disease-Free Survival; D005260:Female; D019337:Hematologic Neoplasms / Q000191:economics / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D009067:Mouthwashes / Q000008:administration & dosage / Q000191:economics; D012307:Risk Factors; D013280:Stomatitis / Q000191:economics / Q000401:mortality / Q000517:prevention & control; D015996:Survival Rate
chemical_list: D009067:Mouthwashes; D002710:Chlorhexidine
keywords: Cancer; Chlorhexidine; Cost; Effectiveness; HSCT; Oral mucositis; Prevention; Survival