% 0期刊文章%一个Xiuqin Xiong %(音译)% David w .群%梅雷迪思·l·宝蓝% Stephen 23安德鲁·戴维森% %李标志着凯瑟琳·j·T·麦凯% %斯图亚特·R .新西兰%一个金新西兰% John A .脸颊%的弗朗茨·e·Babl % T成本效益强的松治疗贝尔麻痹儿童% B经济评价与一个随机对照试验% D R 10.1212 / WNL 2023%。0000000000207284 % J半岛投注体育官网神经病学% P e2432-e2441 % V 100% N 24% X背景和目标贝尔麻痹是第三个最常见的诊断儿童突发神经功能障碍。儿童用强的松治疗贝尔麻痹的成本效益是未知的。我们的目的是评估的成本效益强的松治疗贝尔麻痹与安慰剂比较,儿童。方法这个经济评价是一个前瞻性计划二次分析的双盲、随机、安慰剂对照优势试验(贝尔麻痹儿童[BellPIC])从2015年到2020年进行。从随机化时间是6个月。6个月< 18岁儿童谁提出的72小时内出现clinician-diagnosed贝尔麻痹,谁完成了试验包括(N = 180)。干预是口服强的松或taste-matched安慰剂服用10天。增量成本效益比率与安慰剂比较强的松估计。成本被认为从卫生保健部门的角度来看,包括贝尔palsy-related药物成本,去看医生和医学测试。有效性是衡量使用质量调整寿命(qaly)基于儿童健康效用9 d。 Nonparametric bootstrapping was performed to capture uncertainties. Prespecified subgroup analysis by age 12 to <18 years vs <12 years was conducted.Results The mean cost per patient was A$760 in the prednisolone group and A$693 in the placebo group over the 6-month period (difference A$66, 95% CI −A$47 to A$179). QALYs over 6 months were 0.45 in the prednisolone group and 0.44 in the placebo group (difference 0.01, 95% CI −0.01 to 0.03). The incremental cost to achieve 1 additional recovery was estimated to be A$1,577 using prednisolone compared with placebo, and cost per additional QALY gained was A$6,625 using prednisolone compared with placebo. Given a conventional willingness-to-pay threshold of A$50,000 per QALY gained (equivalent to US$35,000 or £28,000), prednisolone is very likely cost-effective (probability is 83%). Subgroup analysis suggests that this was primarily driven by the high probability of prednisolone being cost-effective in children aged 12 to <18 years (probability is 98%) and much less so for those <12 years (probability is 51%).Discussion This provides new evidence to stakeholders and policymakers when considering whether to make prednisolone available in treating Bell palsy in children aged 12 to <18 years.Trial Registration Information Australian New Zealand Clinical Trials Registry ACTRN12615000563561.BellPIC=Bell Palsy in Children; CHU9D=Child Health Utility 9D; ED=emergency department; GP=general practitioner; PedsQL=Pediatric Quality of life Inventory; QALY=quality-adjusted life-year %U //www.ebmtp.com/content/neurology/100/24/e2432.full.pdf