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Cost-effective analysis of topical chlorhexidine in hematologic patients at risk for oral mucositis

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Abstract

Objective

The aim of this study was to explore whether management of mucositis with Chlorhexidine (CHX) mouthwash could be a cost-effective method to decrease the risk of mortality and economic burden in hemato-oncologic or hematopoietic stem cell transplantation (HSCT) patients.

Methods

A cost-effectiveness analysis model of prophylactic CHX mouthwash use versus no-CHX mouthwash use for the prevention of oral mucositis was developed for patients undergoing cytotoxic therapy or HSCT. The outcome variable was survival. The primary variables were CHX mouthwash use, probability of mucositis, probability of increased hospital stay, and length of hospital stay. Probability and cost data were obtained from the literature.

Results

Our analysis selected CHX mouthwash use during anticancer treatment as the preferred strategy for the base-case analysis as compared to no CHX mouthwash (marginal value 0.032). There was a $14,391 cost difference per patient between the two strategies.

Conclusion

The results of this study suggest that CHX mouthwash use during anticancer treatment results in an increased survival and decreased cost for the population studied. Using our base-case data, an additional 32 of every 1,000 hemato-oncologic or HSCT patients will survive when employing the preferred strategy of prophylactic CHX mouthwash.

Clinical relevance

CHX mouthwash should be offered for hematologic patients undergoing HSCT or administered with chemotherapy.

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Acknowledgments

We would like to acknowledge the support of Dr. Cyril Meyerowitz who provided the environment that allowed this project to develop.

Conflicts of interest

The authors have no conflict of interest to disclose.

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Authors and Affiliations

  1. Division of Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave., Rochester, 14620, NY, USA

    Sharon Elad

  2. School of Dentistry, University of Minnesota, Minneapolis, MN, USA

    Todd Thierer

  3. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA

    Sharon Elad

Authors
  1. Sharon Elad
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  2. Todd Thierer
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Correspondence to Sharon Elad.

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Elad, S., Thierer, T. Cost-effective analysis of topical chlorhexidine in hematologic patients at risk for oral mucositis. Clin Oral Invest 19, 1843–1850 (2015). https://doi.org/10.1007/s00784-015-1438-z

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  • DOI: https://doi.org/10.1007/s00784-015-1438-z

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