Cost-utility of use of sputum eosinophil counts to guide management in children with asthma

Buendía, Jefferson Antonio; Talamoni, H.

doi:10.1080/02770903.2020.1830412

Cited by 12 publications

(4 citation statements)

References 20 publications

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“…This threshold (US$ 257) can be used as a reference for the control and regulation of prices in the country. Show evidence related to the economic impact this drug is essential to policy makers and physician ( 21) especially in developing countries where economic evaluation of drugs and medical devices in pediatric patients are increasing (17,(22)(23)(24)(25) Our study has some limitations. We used retrospective data reported in a previously cost-effectiveness study, and this information does not exclude the possibility that medical invoices were incomplete or missing data.…”

Section: Discussionmentioning

confidence: 99%

Budget Impact Analysis of Surfactant Therapy for Bronchiolitis In Critically Ill Infants: The Colombian National Health System Perspective

Rodriguez

Patiño

2021

Preprint

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BACKGROUND: Exogen surfactant in mechanically ventilated infants decreased duration of stay in the intensive care unit and had favorable effects on oxygenation and carbon dioxide removal. This study aimed to evaluate the budget impact of surfactant therapy for bronchiolitis in critically ill infants in Colombia.METHODS: Budget impact analysis was performed to estimate the economic impact of surfactant therapy (ST) for the treatment of infants with a diagnosis of bronchiolitis, requiring mechanical ventilation. The analysis considered a 4-year time horizon and Colombian National Health System perspective. The model estimated drug costs associated with current scenario using humidified oxygen or adrenaline nebulization , and new scenario adding exogen surfactant. The size of the target population was calculated using epidemiological national data. Univariate one-way sensitivity analyses and scenario analyses were performed.RESULTS: In the base-case analysis the 4-year costs associated to ST and no-ST were estimated to be US$ 55.188.132 and US$ 55.972.082 respectively, indicating savings for Colombian National Health equal to US% 783.950 if ST is adopted for the routine management of patients with bronchiolitis requiring mechanical ventilation. Results were consistent at variation of most of the model’s parameters; only in case of increases of drug cost of surfactant and daily cost or length of stay in pediatric intensive unit , the savings are reducedCONCLUSION: ST was cost-saving in emergency settings for treating infants with severe bronchiolitis requiring mechanical ventilation. This shift in treatment approach proved to be economically favorable in the Colombian context.

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Section: Discussionmentioning

confidence: 99%

Budget Impact Analysis of Surfactant Therapy for Bronchiolitis In Critically Ill Infants: The Colombian National Health System Perspective

Rodriguez

Patiño

2021

Preprint

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“…This threshold (€49) can be used as a reference for the control and regulation of prices in the country. Show evidence related to the economic impact this drug is essential to policy makers and physician [17] especially in developing countries where economic evaluation of drugs and medical devices in pediatric patients are increasing [18][19][20][21][22].…”

Section: Discussionmentioning

confidence: 99%

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

Buendía¹,

Acuña‐Cordero²,

Rodríguez‐Martínez³

2022

J Investig Allergol Clin Immunol

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Background: Fractional exhaled nitric oxide is a simple, non-invasive measurement of airway inflammation with minimal discomfort with results available within a few minutes. For policymakers, the main concerns is the economic impact implicated in adapting this technology, especially in developing countries. This study to evaluate the budget impact of asthma management using fractional exhaled nitric oxide monitoring in patients between 4 and 18 years of age in Colombia. Methods: A budget impact analysis was performed to evaluate the potential financial impact deriving from Fractional exhaled nitric oxide. The analysis considered a 5-year time horizon and Colombian National Health System perspective. The incremental budget impact was calculated by subtracting the cost of the new treatment, in which FeNO is reimbursed, from the cost of the conventional treatment without FeNO (management based on clinical symptoms (with or without spirometry/peak flow) or asthma guidelines (or both), for asthma-related). Univariate one-way sensitivity analyses were performed. Results: In the base-case analysis the 5-year costs associated to FeNO and no-FeNO were estimated to be € 469.904.130 and € 480.485.149 respectively, indicating savings for Colombian National Health equal to € 10.581.019, if FeNO is adopted for the routine management of patients with persistent asthma. This result was robust in univariate sensitivity one-way analysis. Conclusion: Fractional exhaled nitric oxide was cost-saving in emergency settings for infants with persistent asthma. This evidence can be used by decision-makers in our country to improve clinical practice guidelines and should be replicated to validate their results in other middle-income countries.

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“…However, sputum collection may be challenging in young and uncooperative children, while sputum eosinophils do not seem reliable in predicting future asthma attacks [90,93,103]. Novel saliva biomarkers, such as eotaxin, IL-5, and IL-8, are easier to collect and have shown a strong correlation with the level of asthma control [104], but their role is still to be determined.…”

Section: Biomarkersmentioning

confidence: 99%

Prediction of Asthma Exacerbations in Children

Sarikloglou,

Fouzas,

Paraskakis

2023

JPM

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Asthma exacerbations are common in asthmatic children, even among those with good disease control. Asthma attacks result in the children and their parents missing school and work days; limit the patient’s social and physical activities; and lead to emergency department visits, hospital admissions, or even fatal events. Thus, the prompt identification of asthmatic children at risk for exacerbation is crucial, as it may allow for proactive measures that could prevent these episodes. Children prone to asthma exacerbation are a heterogeneous group; various demographic factors such as younger age, ethnic group, low family income, clinical parameters (history of an exacerbation in the past 12 months, poor asthma control, poor adherence to treatment, comorbidities), Th2 inflammation, and environmental exposures (pollutants, stress, viral and bacterial pathogens) determine the risk of a future exacerbation and should be carefully considered. This paper aims to review the existing evidence regarding the predictors of asthma exacerbations in children and offer practical monitoring guidance for promptly recognizing patients at risk.

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Cost-utility of use of sputum eosinophil counts to guide management in children with asthma

Cited by 12 publications

References 20 publications

Budget Impact Analysis of Surfactant Therapy for Bronchiolitis In Critically Ill Infants: The Colombian National Health System Perspective

Budget Impact Analysis of Surfactant Therapy for Bronchiolitis In Critically Ill Infants: The Colombian National Health System Perspective

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

Prediction of Asthma Exacerbations in Children

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