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Scientific Oral Presentations

Laryngology/Broncho-Esophagology

Session: Scientific Oral Presentation 3 - Laryngology/Broncho-Esophagology

Socioeconomic and Cost Analysis of Off-Label Nebulized Ciprofloxacin-Dexamethasone Following Airway Surgery

Monday, October 13, 2025

10:00 AM - 10:06 AM EDT

Location: 138

Disclosure(s):

Abbey L. Landini, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Nebulized ciprofloxacin-dexamethasone (CPD) is an adjuvant treatment used off-label to optimize healing after airway surgery, but there is limited data regarding its accessibility. This study examined socioeconomic factors influencing CPD utilization and assessed its cost.

Methods: All patients who were prescribed nebulized CPD after endoscopic airway surgery from 2021-24 by a single surgeon were analyzed for associations between CPD access and socioeconomic factors including insurance type and Area Deprivation Index (ADI). The regimen was two milliliters CPD ophthalmic (rarely otic) solution nebulized twice daily for four weeks. A model to estimate CPD cost combined retail pricing from GoodRx with cost-sharing calculations from Medicare plans including Aetna, Blue Cross Blue Shield (BCBS), and Cigna, incorporating co-pays, coinsurance, and deductibles.

Results: Fifty-nine patients were prescribed CPD after airway surgery, and 52/59 (88.1%) filled the prescription. Patients with Medicaid and Medicare were less likely to access CPD than those with commercial insurance (p=0.037). There was no association between ADI and CPD utilization (p=0.514). The estimated cost of CPD otic solution for patients with Medicare Advantage PPO plans was $639 (Aetna), $2,554 (BCBS), and $47 (Cigna), whereas the ophthalmic solution cost $53, $51, and $40, respectively. CPD otic and ophthalmic solutions cost $800 and $255, respectively, utilizing GoodRx without coexistent insurance.

Conclusions: Nebulized CPD was accessible to most patients regardless of ADI, but less available to those with Medicaid and Medicare. Importantly, prescribing the ophthalmic formulation instead of otic appears to significantly reduce cost, which may promote more equitable care postoperatively.

Presenting Author(s)

AL

Abbey L. Landini, BA

Medical Student
Northwestern University Feinberg School of Medicine
Chicago, IL, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Cyrus W. Abrahamson, BA

Medical Student
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States

Disclosure information not submitted.
Jasmine N. Stewart, MS

Medical Student
New York Institute of Technology College of Osteopathic Medicine-Jonesboro
Omaha, NE, United States

Disclosure information not submitted.
Jonathan Philip Kuriakose, MD, MS

Resident Physician
Northwestern Medicine
Chicago, IL, United States

Disclosure information not submitted.
JB

James A. Burns, MD

Associate Professor
Harvard Medical School/Massachusetts General Hospital, Center for Laryngeal Surgery & Voice Rehabilitation
Boston, Massachusetts, United States

Disclosure information not submitted.

Senior Author(s)

AS

Andrew P. Stein, MD

Assistant Professor
Feinberg School of Medicine
Chicago, IL, United States

Disclosure information not submitted.