Department of Pharmacology and Toxicology, Research Group in Pharmacology and Toxicology "INFARTO", University of Antioquia, Medellin, Colombia.
Pediatr Pulmonol. 2022 Oct;57(10):2511-2517. doi: 10.1002/ppul.26067. Epub 2022 Aug 3.
Despite the growing evidence on efficacy, little is known regarding the efficiency of Vitamin A supplementation to decrease the probability of chronic lung disease (CLD) in preterm infants. This study aims to determine the cost-utility of Vitamin A to prevent CLD in preterm infants in Colombia.
A decision tree model was used to estimate the cost and quality-adjusted life-years (QALYs) of Vitamin A supplementation in preterm infants. Multiple sensitivity analyses were conducted to evaluate the robustness of the model. Cost-effectiveness was evaluated at a willingness-to-pay value of US$5180.
Vitamin A was associated with lower costs and higher QALYs. The expected annual cost per patient with Vitamin A was US$1579 (95% CI US$1555-US$1585) and without Vitamin A was US$1913 (95% CI US$1891-US$1934). The QALYs per person estimated with Vitamin A was 0.66 (95% CI 0.66-0.67) and without Vitamin A was 0.61 (95% CI 0.60-0.61). This position of absolute dominance (Vitamin A has lower costs and higher QALYs than without Vitamin A) is unnecessary to estimate the incremental cost-effectiveness ratio.
Our economic evaluation shows that Vitamin A is cost-effective to reduce the incidence rate of CLD in premature infants in Colombia. Our study provides evidence that should be used by decision-makers to improve clinical practice guidelines.
尽管关于疗效的证据越来越多,但对于补充维生素 A 以降低早产儿慢性肺病(CLD)发生率的效率知之甚少。本研究旨在确定维生素 A 预防哥伦比亚早产儿 CLD 的成本效益。
使用决策树模型来估计早产儿补充维生素 A 的成本和质量调整生命年(QALY)。进行了多次敏感性分析以评估模型的稳健性。在支付意愿值为 5180 美元的情况下评估成本效益。
维生素 A 与较低的成本和较高的 QALY 相关。接受维生素 A 的患者的年预期成本为 1579 美元(95%置信区间为 1555-1585 美元),未接受维生素 A 的患者的年预期成本为 1913 美元(95%置信区间为 1891-1934 美元)。接受维生素 A 的患者的人均 QALY 估计为 0.66(95%置信区间为 0.66-0.67),未接受维生素 A 的患者的人均 QALY 估计为 0.61(95%置信区间为 0.60-0.61)。这种绝对优势的立场(维生素 A 的成本低于不使用维生素 A 的成本,且 QALY 更高)对于估计增量成本效益比是不必要的。
我们的经济评估表明,维生素 A 可以降低哥伦比亚早产儿 CLD 的发生率,具有成本效益。我们的研究提供了决策者应使用的证据,以改善临床实践指南。