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Cost- Utility Analysis of the Inhaled Steroids Available in a Developing Country for the Management of Paediatric Patients with Persistent Asthma.
MedLine Citation:
PMID:  23356720     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Introduction: The choice between the different treatments available can have a great impact on the costs of asthma. Objectives: The objective of this study was to estimate the incremental cost-utility ratio of three inhaled corticosteroids (ICs): budesonide (BUD), fluticasone propionate (FP) and ciclesonide, compared to beclomethasone dipropionate (BDP) (the only IC included in the Compulsory Health Insurance Plan of Colombia). Methods: A Markov-type model was developed to estimate costs and health outcomes of a simulated cohort of patients less than 18 years of age with persistent asthma treated over a 12 months period. Effectiveness parameters were obtained from a systematic review of the literature. Cost data were obtained from a hospital's bills and from the national manual of drug prices. The study assumed the perspective of the national healthcare in Colombia. The main outcome was the variable "quality-adjusted life years" (QALY). Results: While treatment with BDP was associated with the lowest cost (£106.16 average cost per patient during 12 months), treatment with FP resulted in the greatest gain in QUALYs (0.9325 QALYs). FP was associated with a greater gain in QALYs compared to BUD and ciclesonide (0.9325 vs. 0.8999 and 0.9051 QALYs, respectively) at lower costs (£231.19 vs. £309.27 and £270.15, respectively), thus leading to dominance. The incremental cost-utility ratio of FP compared to BDP was £19,835.28 per QALY. Conclusions: BDP is the most cost-effective therapy for treating pediatric patients with persistent asthma when willingness to pay (WTP) is less than £21,129.22/QALY, otherwise, FP is the most cost-effective therapy.
Authors:
Carlos E Rodríguez-Martínez; Mónica P Sossa-Briceño; Jose A Castro-Rodriguez
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-28
Journal Detail:
Title:  The Journal of asthma : official journal of the Association for the Care of Asthma     Volume:  -     ISSN:  1532-4303     ISO Abbreviation:  J Asthma     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106454     Medline TA:  J Asthma     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1. Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia; Department of Pediatric Pulmonology and Pediatric Critical Care Medicine, School of Medicine, Universidad El Bosque ; Research Unit, Military Hospital of Colombia, Bogota , Colombia.
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