Buendía Jefferson Antonio, Patiño Diana Guerrero
Research group in Pharmacology and Toxicology "INFARTO", Department of Pharmacology and Toxicology, University of Antioquia, Carrera 51D #62-29, Medellin, Colombia.
Cost Eff Resour Alloc. 2024 Nov 14;22(1):83. doi: 10.1186/s12962-024-00589-2.
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.
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$5180.
The QALYs per person were 0,93 with VDS and 0,92 without VDS. The total costs per person were US$ 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.
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.
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。
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。
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。
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。