Abstract
IntroductionFractional 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.MethodsA 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.ResultsThe model showed that fractional exhaled nitric oxide monitoring was associated with a lower total cost than standard therapy (US $1333 vs. US $1452 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.ConclusionAsthma 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.
Highlights
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
We aimed to evaluate the costeffectiveness of asthma management using fractional exhaled nitric oxide monitoring in patients between 4 and 18 years of age
The model showed that Fractional exhaled nitric oxide (FeNO) was associated with lower total costs than standard therapy (US $1333 vs. US $1452 average cost per patient) and higher Quality-adjusted life years (QALYs) (0.93 vs 0.92 average per patient), showing its dominance
Summary
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. The periodic assessment and early management of airway inflammation in patients with asthma are the principal strategies to prevent hospitalizations as recommended by international and local clinical guidelines [1]. Fractional exhaled nitric oxide (FeNO) may be a surrogate marker for type 2 airway inflammation [2]. FeNO is a simple, non-invasive measurement of airway inflammation with minimal discomfort to the patient and with results available within a few minutes. A meta-analysis of eight clinical trials in children found that FeNO-guided treatment
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have