Article

Economic appraisal can help guide policy-making for purchasing decisions,
and treatment and management algorithms for health interventions. We conducted a
systematic review of economic studies in cerebral palsy (CP) to inform future
research. METHOD: Economic studies published since 1970 were identified from
seven databases. Two reviewers independently screened abstracts and extracted
data following the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guidelines. Any discrepancies were resolved by discussion.
RESULTS: Of 980 identified references, 115 were included for full-text
assessment. Thirteen articles met standard criteria for a full economic
evaluation, two as partial economic evaluations, and 18 as cost studies. Six were
full economic evaluations alongside clinical studies or randomized controlled
trials, whereas seven involved modelling simulations. The economic case for
administration of magnesium sulfate for imminent preterm birth is compelling,
achieving both health gain and cost savings. Current literature suggests
intrathecal baclofen therapy and botulinum toxin injection are cost-effective,
but stronger evidence for long-term effects is needed. Lifestyle and web-based
interventions are inexpensive, but broader measurement of outcomes is required.
INTERPRETATION: Prevention of CP would avoid significant economic burden. Some
treatments and interventions have been shown to be cost-effective, although
stronger evidence of clinical effectiveness is needed. What this paper adds
Cost-effectiveness evidence shows prevention is the most significant strategy.
Some treatments are cost-effective, but stronger evidence for long-term
effectiveness is required. Comparison of treatment costs is challenging owing to
variations in methodologies and varying clinical indications.
CI - (c) 2018 Mac Keith Press.

Langue : ANGLAIS