Buendía Jefferson Antonio, Patiño Diana Guerrero
Research group in Pharmacology and Toxicology "INFARTO", Department of Pharmacology and Toxicology, University of Antioquia, Medellin, Colombia.
Cost Eff Resour Alloc. 2023 Apr 6;21(1):23. doi: 10.1186/s12962-023-00433-z.
Increasing evidence has demonstrated the effectiveness and safety of vitamin D supplementation to prevent acute respiratory infections in children. More economic evaluations incorporating the new evidence and in the pediatric population are needed to know the efficiency of this treatment. This study aimed to determine the cost-utility of vitamin D supplementation to prevent acute respiratory infections in pediatric patients.
A decision tree model was used to estimate the cost and quality-adjusted life-years (QALYs) of vitamin D supplementation in healthy school children between 1 and 16 years. Multiple sensitivity analyses were conducted. Cost-effectiveness was evaluated at a willingness-to-pay (WTP) value of $19,000.
The base-case analysis showed that vitamin D supplementation was associated with lower costs and higher QALYs than strategy without this supplementation. The QALYs per person estimated in the model for those treatments were 0,99 with vitamin D supplementation and 0,98 without vitamin D supplementation. The total costs per person were US$ 1354 for vitamin D supplementation and US$ 1948 without vitamin D supplementation. This position of absolute dominance of vitamin D supplementation makes it unnecessary to estimate the incremental cost-effectiveness ratio.
In conclusion, our study shows that Vitamin D supplementation is a cost-effective strategy to prevent ARI in pediatric patients, from a societal perspective.
越来越多的证据表明补充维生素D对预防儿童急性呼吸道感染具有有效性和安全性。需要更多纳入新证据并针对儿科人群的经济学评估，以了解这种治疗方法的效率。本研究旨在确定补充维生素D预防儿科患者急性呼吸道感染的成本效益。
采用决策树模型来估计1至16岁健康在校儿童补充维生素D的成本和质量调整生命年（QALY）。进行了多项敏感性分析。在支付意愿（WTP）值为19,000美元的情况下评估成本效益。
基础案例分析表明，与不补充维生素D的策略相比，补充维生素D的成本更低，QALY更高。该模型中估计的那些治疗方法每人的QALY，补充维生素D为0.99，不补充维生素D为0.98。补充维生素D的人均总成本为1354美元，不补充维生素D为1948美元。补充维生素D的这种绝对优势地位使得无需估计增量成本效益比。
总之，我们的研究表明，从社会角度来看，补充维生素D是预防儿科患者急性呼吸道感染的一种具有成本效益的策略。
