Analysis of the Budget Impact of Fractional Exhaled Nitric Oxide Monitoring in the Management of Childhood Asthma: The Colombian National Health System Perspective

被引:5
作者
Buendia, J. A. [1 ]
Acuna-Cordero, R. [2 ]
Rodriguez-Martinez, C. E. [3 ]
机构
[1] Univ Antioquia, Dept Farmacol & Toxicol, Grp Invest Farmacol & Toxicol, Fac Med, Medellin, Colombia
[2] Univ Mil Nueva Granada, Hosp Mil Cent, Fac Med, Dept Neumol Pediat,Dept Paediat, Bogota, Colombia
[3] Univ Nacl Colombia, Sch Med, Dept Pediat, Bogota, Colombia
关键词
Fractional exhaled nitric oxide; Persistent asthma; Colombia; COST-EFFECTIVENESS;
D O I
10.18176/jiaci.0690
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: Fractional exhaled nitric oxide (FeNO) testing is a simple, noninvasive approach to assessing airway inflammation with minimal discomfort that provides results within a few minutes. For policy makers, the economic impact of this technology is the main concern, especially in developing countries. We evaluated the budget impact of asthma management using FeNO monitoring in patients aged between 4 and 18 years in Colombia. Methods: A budget impact analysis was performed to evaluate the potential cost of FeNO monitoring. The analysis was based on a 5-year time horizon and performed from the perspective of the Colombian National Health System. The incremental budget impact was calculated by subtracting the cost of the new treatment, in which FeNO is reimbursed, from the cost of conventional treatment without FeNO (management based on clinical symptoms [with or without spirometry/peak flow] or asthma guidelines [or both] for asthma-related Results: In the base case analysis the 5-year costs associated with FeNO and non-FeNO were estimated to be euro 469 904 130 and euro 480 485 149, respectively, indicating savings for the Colombian National Health System of euro 10 581 019 if FeNO is adopted for the routine management of patients with persistent asthma. This result proved to be robust in the univariate 1-way sensitivity analysis. Conclusion: FeNO monitoring generated cost savings in emergency settings for infants with persistent asthma. This evidence can be used by decision makers in Colombia to improve clinical practice guidelines and should be replicated to validate the results in other middle-income countries.
引用
收藏
页码:200 / 205
页数:6
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