Nebulized epinephrine plus oral dexamethasone is the most cost-effective treatment in bronchiolitis

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Using data from the Canadian Bronchiolitis Epinephrine Steroid Trial, the authors assessed the cost-effectiveness of treatments with epinephrine and dexamethasone for infants between 6 weeks and 12 months of age with bronchiolitis.

Comparators were:

- nebulized epinephrine plus oral dexamethasone
- nebulized epinephrine alone
- oral dexamethasone alone
- no active treatment

The combination of nebulized epinephrine plus oral dexamethasone was dominant over the other 3 comparators in that it was both the most effective and least costly. Average societal costs were $1,115 for the combination therapy, $1,210 for no active treatment.

The average time to curtailment of all symptoms was 12 days for the combination therapy, 12.7 days for no active treatment.

Treating infants with bronchiolitis with a combination of nebulized epinephrine plus oral dexamethasone is the most cost-effective treatment option.

References:
Cost-effectiveness of Epinephrine and Dexamethasone in Children With Bronchiolitis. PEDIATRICS Vol. 126 No. 4 October 2010, pp. 623-631 (doi:10.1542/peds.2009-3663)