Cost Utility of Fractional Exhaled Nitric Oxide Monitoring for the Management of Children Asthma
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.
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Posted 16 Dec, 2020
Received 29 Jan, 2021
On 28 Jan, 2021
On 28 Jan, 2021
Invitations sent on 12 Jan, 2021
On 10 Dec, 2020
On 10 Dec, 2020
On 10 Dec, 2020
On 10 Dec, 2020
Cost Utility of Fractional Exhaled Nitric Oxide Monitoring for the Management of Children Asthma
Posted 16 Dec, 2020
Received 29 Jan, 2021
On 28 Jan, 2021
On 28 Jan, 2021
Invitations sent on 12 Jan, 2021
On 10 Dec, 2020
On 10 Dec, 2020
On 10 Dec, 2020
On 10 Dec, 2020
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