Cost utility of fractional exhaled nitric oxide monitoring for the management of children asthma

ABSTRACT: Introduction: Fractional exhaled nitric oxide is a simple, non-invasive measurement of airway inflammation with minimal discomfort to the patient and with results available within a few minutes. This study aimed to evaluate the cost-effectiveness of asthma management using fractional exhaled nitric oxide monitoring in patients between 4 and 18 years of age. Methods: A Markov model was used to estimate the cost-utility of asthma management using fractional exhaled nitric oxide monitoring versus asthma management without using fractional exhaled nitric oxide monitoring (standard therapy) in patients between 4 and 18 years of age. Cost data were obtained from a retrospective study on asthma from a tertiary center, in Medellin, Colombia, while probabilities of the Markov model and utilities were obtained from the systematic review of published randomized clinical trials. The analysis was carried out from a societal perspective. Results: The model showed that fractional exhaled nitric oxide monitoring was associated with a lower total cost than standard therapy (US $1333 vs. US $1452 average cost per patient) and higher QALYs (0.93 vs. 0.92 average per patient). The probability that fractional exhaled nitric oxide monitoring provides a more cost-effective use of resources compared with standard therapy exceeds 99% for all willingness-to-pay thresholds. Conclusion: Asthma management using fractional exhaled nitric oxide monitoring was cost-effective for treating patients between 4 and 18 years of age with mild to moderate allergic asthma. Our study suggests evidence that could be used by decision-makers to improve clinical practice guidelines, but this should be replicated in different clinical settings.

• Autores: Buendía Rodríguez, Jefferson Antonio; Acuña Cordero, Ranniery; Rodríguez Martínez, Carlos Enrique
• Tipo de recurso: Article of investigation
• Fecha de publicación: 2021
• Institución: Universidad de Antioquia
• Repositorio: Repositorio UdeA
• Idioma: eng
• OAI Identifier: oai:bibliotecadigital.udea.edu.co:10495/44933
• Acceso en línea: https://hdl.handle.net/10495/44933
• Palabra clave: Economía y Organizaciones para la Atención de la Salud; Health Care Economics and Organizations; Salud Pública; Public Health; Atención a la Salud; Delivery of Health Care; Asma; Asthma; Análisis Costo-Beneficio; Cost-Benefit Analysis; Prueba de Óxido Nítrico Exhalado Fraccionado; Fractional Exhaled Nitric Oxide Testing; https://id.nlm.nih.gov/mesh/D004472; https://id.nlm.nih.gov/mesh/D011634; https://id.nlm.nih.gov/mesh/D003695; https://id.nlm.nih.gov/mesh/D001249; https://id.nlm.nih.gov/mesh/D003362; https://id.nlm.nih.gov/mesh/D000089142
• Rights: openAccess
• License: https://creativecommons.org/licenses/by/4.0/