Abstract
Objectives
To evaluate cost-effectiveness between oral sedatives melatonin and triclofos sodium used to perform sleep electroencephalography (EEG) in pediatric patients and develop a criterion for resource allocation by the institution.
Methods
This prospective study was conducted alongside the randomized controlled trial conducted at a tertiary care hospital, wherein pediatric patients arriving for sleep EEG were randomized to receive melatonin dosed at 0.3 mg/kg (< 10 kg), 3 mg (10–15 kg), and 6 mg (> 15 kg) and triclofos at 50 mg/kg (maximum dose 1 g, 6 mo to 11 y; 2 g, 11 to 18 y) after due consent. The cost-effectiveness analysis was performed from the healthcare institution’s perspective. Successful EEG and abnormal EEG were the effectiveness parameters.
Results
Two hundred twenty-eight patients were divided equally between two groups. Melatonin (N = 114) and triclofos (N = 114) recorded successful EEG in 89.4% and 91.2% patients and abnormal EEG in 49% and 42.3% patients, respectively (p > 0.05). The total direct cost incurred was INR 1881.75 (USD 26.6) and INR 2772.5 (USD 39.2) for melatonin and triclofos, respectively (p < 0.05). The cost-effectiveness ratio-1 (CER-1) for melatonin and triclofos per successful EEG recorded was INR 18.45 (USD 0.39) and INR 26.66 (USD 0.58), respectively. The CER-2 for melatonin and triclofos per abnormal EEG detected was INR 37.64 (USD 0.53) and INR 63.01 (USD 0.89), respectively.
Conclusions
Melatonin is more cost-effective than triclofos when charged based on individual dose requirements. Hospitals, diagnostic centers, healthcare institutions may consider resource-utilization–based costing system for cost-effective allocation of resources.
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Acknowledgements
The authors would like to extend their gratitude to the EEG technicians for their support and the hospital management for providing infrastructure.
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HK, SK, ND and SL participated in the study design, data acquisition, analysis and interpretation of data, statistical analysis, and drafting of the manuscript. KS and BKP participated in the study concept, study design, discussion, revising of manuscript, study supervision, and coordination.
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Dr. Asawari Raut, Head of Department, Department of Clinical Pharmacy, Poona College of Pharmacy, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India.
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The study was approved by the ‘Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital’ Institutional Ethics Committee.
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Kaur, H., Srivastava, K., Karmakar, S. et al. Melatonin and Triclofos Sodium to Execute Sleep Electroencephalography in Pediatric Patients: A Cost-Effectiveness Analysis Alongside a Randomized Controlled Trial. Indian J Pediatr 90, 893–898 (2023). https://doi.org/10.1007/s12098-022-04246-5
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DOI: https://doi.org/10.1007/s12098-022-04246-5