Buendía Jefferson Antonio, Acuña-Cordero Ranniery
Grupo de Investigación en Farmacología y Toxicología (INFARTO). Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad de Antioquia, Carrera 51D #62-29, Medellín, Colombia.
Departamento de Neumología Pediátrica, Hospital Militar Central, Departamento de Pediatría, Facultad de Medicina, Universidad Militar Nueva Granada, Bogotá, Colombia.
BMC Health Serv Res. 2020 Nov 2;20(1):1001. doi: 10.1186/s12913-020-05814-1.
Pharmacological treatment for bronchiolitis is primarily supportive because bronchodilators, steroids, and antibiotics, show little benefit. Clinical studies have suggested that nebulized 3% hypertonic solution is useful for infants with bronchiolitis. This study aims to evaluate the cost-effectiveness of the HS inhalations in infant bronchiolitis in a tropical country.
Decision tree analysis was used to calculate the expected costs and QALYs. All cost and use of resources were collected directly from medical invoices of 193 patient hospitalized with diagnosis of bronchiolitis in tertiary centers, of Rionegro, Colombia. The utility values applied to QALYs calculations were collected from the literature. The economic analysis was carried out from a societal perspective.
The model showed that nebulized 3% hypertonic solution, was associated with lower total cost than controls (US $200vs US $240 average cost per patient), and higher QALYs (0.92 vs 0.91 average per patient); showing dominance. A position of dominance negates the need to calculate an incremental cost-effectiveness ratio.
The nebulized 3% hypertonic solution was cost-effective in the inpatient treatment of infant bronchiolitis. Our study provides evidence that should be used by decision-makers to improve clinical practice guidelines and should be replicated to validate their results in other tropical countries.
细支气管炎的药物治疗主要是支持性治疗，因为支气管扩张剂、类固醇和抗生素几乎没有益处。临床研究表明，雾化吸入3%高渗溶液对患细支气管炎的婴儿有用。本研究旨在评估在一个热带国家雾化吸入高渗溶液治疗婴儿细支气管炎的成本效益。
采用决策树分析来计算预期成本和质量调整生命年。所有成本和资源使用情况均直接从哥伦比亚里奥内格罗市三级中心193例诊断为细支气管炎的住院患者的医疗发票中收集。应用于质量调整生命年计算的效用值从文献中收集。经济分析从社会角度进行。
模型显示，雾化吸入3%高渗溶液与对照组相比，总成本更低（每位患者平均成本为200美元对240美元），质量调整生命年更高（每位患者平均为0.92对0.91）；显示出优势。优势地位使得无需计算增量成本效益比。
雾化吸入3%高渗溶液在婴儿细支气管炎的住院治疗中具有成本效益。我们的研究提供了证据，决策者应利用这些证据来改进临床实践指南，并且该研究应在其他热带国家重复进行以验证其结果。
