Antonio Buendía Jefferson, Rodriguez-Martinez Carlos E, Sossa-Briceño Monica P
Research group in Pharmacology and Toxicology "INFARTO", Department of Pharmacology and Toxicology, University of Antioquia, Medellín, Colombia.
Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia.
J Asthma. 2023 May;60(5):951-959. doi: 10.1080/02770903.2022.2110113. Epub 2022 Sep 14.
Uncontrolled asthma significantly impairs health-related quality of life and work productivity. Some add-on therapies, such as vitamin D supplements, safely reduce the rate of asthma exacerbation. The purpose of this study was to assess the cost-utility of vitamin D supplementation in adults with mild to moderate persistent asthma in Colombia.
A Markov model was created to estimate the cost and quality-adjusted life-years (QALYs) of patients with severe asthma in Colombia. Total costs and QALYs of two therapy strategies, vitamin D supplementation plus ICS versus ICS alone, were calculated over a one-year time horizon. Deterministic and probability sensitivity analyses were conducted, and cost-effectiveness was evaluated at a willingness-to-pay value of $5,180 per QALY gained.
The base-case analysis showed that compared with no supplementation, vitamin D supplementation was associated with higher costs and higher QALYs. The expected annual cost per patient with vitamin D supplementation was US$1338 and without this supplementation it was US$1095. The QALYs per person estimated with vitamin D supplementation was 0.80, and without this supplementation it was 0.63. The estimated incremental cost-effectiveness ratio (ICER) was US$1583 per QALY.
Add-on vitamin D supplement was cost-effective when added to the usual care in patients with mild to moderate persistent asthma. Our study provides evidence that should be used by decision-makers to improve clinical practice guidelines.
未得到控制的哮喘会显著损害与健康相关的生活质量和工作效率。一些附加疗法，如补充维生素D，可安全降低哮喘恶化率。本研究的目的是评估在哥伦比亚患有轻至中度持续性哮喘的成年人中补充维生素D的成本效益。
创建一个马尔可夫模型来估计哥伦比亚重度哮喘患者的成本和质量调整生命年（QALY）。在一年的时间范围内计算两种治疗策略（补充维生素D加吸入性糖皮质激素（ICS）与单独使用ICS）的总成本和QALY。进行了确定性和概率敏感性分析，并以每获得一个QALY支付意愿值5180美元来评估成本效益。
基础病例分析表明，与不补充相比，补充维生素D的成本更高，QALY也更高。补充维生素D的每位患者的预期年度成本为1338美元，不补充则为1095美元。补充维生素D估计的每人QALY为0.80，不补充则为0.63。估计的增量成本效益比（ICER）为每QALY 1583美元。
对于轻至中度持续性哮喘患者，在常规治疗中添加维生素D补充剂具有成本效益。我们的研究提供了可供决策者用于改进临床实践指南的证据。
