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

IF 4.8
J A Buendía, R Acuña-Cordero, C E Rodriguez-Martinez
{"title":"Analysis of the Budget Impact of Fractional Exhaled Nitric Oxide Monitoring in the Management of Childhood Asthma: The Colombian National Health System Perspective.","authors":"J A Buendía,&nbsp;R Acuña-Cordero,&nbsp;C E Rodriguez-Martinez","doi":"10.18176/jiaci.0690","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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 cases). Univariate 1-way sensitivity analyses were performed.</p><p><strong>Results: </strong>In the base case analysis the 5-year costs associated with FeNO and non-FeNO were estimated to be €469 904 130 and €480 485 149, respectively, indicating savings for the Colombian National Health System of €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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":520676,"journal":{"name":"Journal of investigational allergology & clinical immunology","volume":" ","pages":"200-205"},"PeriodicalIF":4.8000,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of investigational allergology & clinical immunology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.18176/jiaci.0690","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/4/13 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 3

Abstract

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 cases). Univariate 1-way sensitivity analyses were performed.

Results: In the base case analysis the 5-year costs associated with FeNO and non-FeNO were estimated to be €469 904 130 and €480 485 149, respectively, indicating savings for the Colombian National Health System of €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.

分次呼气一氧化氮监测在儿童哮喘管理中的预算影响分析:哥伦比亚国家卫生系统的观点。
背景:分式呼出一氧化氮(FeNO)检测是一种简单、无创的评估气道炎症的方法,具有最小的不适,可在几分钟内提供结果。对于决策者来说,这项技术的经济影响是主要关注的问题,特别是在发展中国家。我们评估了哥伦比亚4至18岁患者使用FeNO监测哮喘管理的预算影响。方法:采用预算影响分析方法评估FeNO监测的潜在成本。该分析基于5年时间范围,并从哥伦比亚国家卫生系统的角度进行。增量预算影响是通过从无FeNO的传统治疗(根据临床症状[有或没有肺活量测定/峰值流量]或哮喘指南[或两者兼有]进行管理)的成本中减去FeNO得到报销的新治疗的成本来计算的。进行单变量单向敏感性分析。结果:在基本病例分析中,与FeNO和非FeNO相关的5年成本估计分别为469 904 130欧元和480 485 149欧元,这表明如果将FeNO用于持续性哮喘患者的常规管理,为哥伦比亚国家卫生系统节省了10 581 019欧元。该结果在单变量单向敏感性分析中被证明是稳健的。结论:FeNO监测为婴幼儿持续性哮喘的急诊治疗节省了费用。哥伦比亚的决策者可以利用这一证据来改进临床实践指南,并应在其他中等收入国家复制以验证结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信