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Cost Utility of Fractional Exhaled Nitric Oxide Monitoring for the Management of Children Asthma
Jefferson Antonio Buendia
Universidad de Antioquia Facultad de Medicina
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2404-6612
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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 $1,333 vs. US $1,452 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.
Keywords
health economics, public health, healthcare
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CURRENT STATUS: Under Review
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Posted 16 Dec, 2020
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This preprint is under consideration at Cost Effectiveness and Resource Allocation. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Cost Utility of Fractional Exhaled Nitric Oxide Monitoring for the Management of Children Asthma
Jefferson Antonio Buendia
Universidad de Antioquia Facultad de Medicina
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2404-6612
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 16 Dec, 2020
No community comments so far
Reviewers invited
Invitations sent on 12 Jan, 2021
First submitted
On 10 Dec, 2020
Editor assigned
On 10 Dec, 2020
Submission checks complete
On 10 Dec, 2020
Editor invited
On 10 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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 $1,333 vs. US $1,452 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.
Figure 1
Figure 2
Figure 3