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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Appl+Health+Econ+Health+Policy
2016 ; 14
(2
): 205-15
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
The Long-Term Cost to the UK NHS and Social Services of Different Durations of IV
Thiamine (Vitamin B1) for Chronic Alcohol Misusers with Symptoms of Wernicke s
Encephalopathy Presenting at the Emergency Department
#MMPMID26718853
Wilson EC
; Stanley G
; Mirza Z
Appl Health Econ Health Policy
2016[Apr]; 14
(2
): 205-15
PMID26718853
show ga
BACKGROUND: Wernicke's encephalopathy (WE) is an acute neuropsychiatric condition
caused by depleted intracellular thiamine, most commonly arising in chronic
alcohol misusers, who may present to emergency departments (EDs) for a variety of
reasons. Guidelines recommend a minimum 5-day course of intravenous (IV) thiamine
in at-risk patients unless WE can be excluded. OBJECTIVE: To estimate the cost
impact on the UK public sector (NHS and social services) of a 5-day course of IV
thiamine, vs a 2- and 10-day course, in harmful or dependent drinkers presenting
to EDs. METHODS: A Markov chain model compared expected prognosis of patients
under alternative admission strategies over 35 years. Model inputs were derived
from a prospective cohort study, expert opinion via structured elicitation and
NHS costing databases. Costs (2012/2013 price year) were discounted at 3.5 %.
RESULTS: Increasing treatment from 2 to 5 days increased acute care costs but
reduced the probability of disease progression and thus reduced the expected net
costs by GBP87,000 per patient (95 % confidence interval GBP19,300 to GBP172,300)
over 35 years. CONCLUSIONS: Increasing length of stay to optimize IV thiamine
replacement will place additional strain on acute care but has potential UK
public sector cost savings. Social services and the NHS should explore
collaborations to realise both the health benefits to patients and savings to the
public purse.