P0560 COST-EFFECTIVENESS OF ONDANSETRON TREATMENT IN VOMITING ASSOCIATED WITH ACUTE GASTROENTERITIS IN CHILDREN

Abstract

Introduction: Acute gastroenteritis (AGE) is a common pediatric illness which has high morbidity, mortality, and cost. Oral rehydration therapy (ORT) remains an essential part of treatment. Concomitant vomiting might limit successful ORT. Oral or intravenous ondansetron has recently been shown to be effective in decreasing vomiting associated with AGE and reducing the need for hospital admission (1, 2). It was mentioned in a recent CDC recommendations report that a cost–effective analysis should be undertaken before routine pharmacological therapy is recommended (3). The aim of this study was to evaluate the cost-effectiveness of intravenous ondansetron for treatment of vomiting associated with AGE in children in regard to reducing hospital admission days. Methods: A decision tree was constructed comparing ondansetron with placebo. Probability values, payoffs and costs were obtained from a previously published study (1). Calculations were made using DATA 3.0 decision analysis software (TreeAge Software, INC., Williamstown, MA, USA). Results: Ondansetron was more cost-effective, $91 per hospital admission day reduced, when compared to placebo of $284. Placebo (i.e. costs more and less effective) was dominated by ondansetron. Placebo was costly because of cost incurred by higher admission rate. One way sensitivity analysis showed admission rate in the ondansetron group would have to increase from 7.5% to 20.8% before reaching a threshold (cost equivalence) with placebo. Conclusion: Intravenous ondansetron is cost-effective in treating vomiting associated with AGE in children in the emergency room and preventing hospital admission.