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高剂量补充维生素D以减少儿童肺炎复发的成本效益分析

Cost-effectiveness of high-dose vitamin D supplementation to reduce the occurrence of repeat episodes of pneumonia in children.

作者信息

Buendía Jefferson Antonio, Patiño Diana Guerrero

机构信息

Research group in Pharmacology and Toxicology "INFARTO", Department of Pharmacology and Toxicology, University of Antioquia, Carrera 51D #62-29, Medellin, Colombia.

出版信息

Cost Eff Resour Alloc. 2024 Nov 14;22(1):83. doi: 10.1186/s12962-024-00589-2.

Abstract

INTRODUCTION

Despite the growing evidence on efficacy, little is known regarding the efficiency of Vitamin D supplementation (VDS) to reduce the incidence of repeat episodes of pneumonia in children. This study aimed to determine the cost-utility of VDS to reduce the incidence rate of repeat episodes of pneumonia in children.

METHODS

A decision tree model was used to estimate the cost and quality-adjusted life-years (QALYs) of VDS in a patient aged 2 to 60 months with a clinical diagnosis of community-acquired pneumonia requiring in-hospital management. Multiple sensitivity analyses were conducted to evaluate the robustness of the model. Cost-effectiveness was evaluated at a willingness-to-pay (WTP) value of US$5180.

RESULTS

The QALYs per person were 0,93 with VDS and 0,92 without VDS. The total costs per person were US$ 1148 for VDS and US$ 1284 without VDS. This position of absolute dominance of VDS makes it unnecessary to estimate the incremental cost-effectiveness ratio. The ICER was sensitive to changes in the relative risk of Vitamin D supplementation.

CONCLUSION

In conclusion, our study shows that VDS is a cost-effective to reduce the incidence rate of repeat episodes of pneumonia in children, from a societal perspective. However, the sensitivity of ICER to relative risk makes it necessary to take the results of this economic evaluation with caution.

摘要

引言

尽管关于维生素D补充剂(VDS)有效性的证据越来越多,但对于其降低儿童肺炎复发率的效率却知之甚少。本研究旨在确定VDS降低儿童肺炎复发率的成本效益。

方法

采用决策树模型来估计年龄在2至60个月、临床诊断为社区获得性肺炎且需要住院治疗的患者使用VDS的成本和质量调整生命年(QALYs)。进行了多项敏感性分析以评估模型的稳健性。成本效益评估的支付意愿(WTP)值为5180美元。

结果

使用VDS时每人的QALYs为0.93,不使用VDS时为0.92。使用VDS时每人的总成本为1148美元,不使用VDS时为1284美元。VDS的这种绝对优势地位使得无需估计增量成本效益比。增量成本效益比(ICER)对维生素D补充剂相对风险的变化敏感。

结论

总之,我们的研究表明,从社会角度来看,VDS是降低儿童肺炎复发率的一种具有成本效益的方法。然而,ICER对相对风险的敏感性使得有必要谨慎对待这一经济评估结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0e5/11566492/0dd952410ba6/12962_2024_589_Fig1_HTML.jpg

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