Rodríguez-Martínez Carlos E, Sossa-Briceño Monica P, Buendia Jefferson Antonio
Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia.
Department of Pediatric Pulmonology, School of Medicine, Universidad El Bosque, Bogota, Colombia.
Pediatr Pulmonol. 2025 Jan;60(1):e27466. doi: 10.1002/ppul.27466. Epub 2024 Dec 31.
Since 2019 as-needed low-dose ICS-formoterol in a single inhaler has been recommended for treatment of mild asthma in children aged more than 12 years. Alternatively, the use of ICS-albuterol has been proposed in countries where ICS-formoterol is not available or affordable. The aim of the present study was to evaluate the cost-utility of as-needed ICS-albuterol in separate inhalers compared to ICS-formoterol in a single inhaler as reliever therapy in pediatric patients with mild asthma living in Colombia.
A Markov-type model was developed to estimate the costs and health outcomes of a simulated cohort of pediatric patients with mild asthma treated for 12 months. The effectiveness data and transition probabilities were obtained from relevant randomized clinical trials (RCTs). Cost data were obtained from official databases provided by the Colombian Ministry of Health. The main outcome was the variable "quality-adjusted life-years" (QALYs).
The base-case analysis showed that compared with the use of as-needed ICS-albuterol in separate inhalers, the use of ICS-formoterol in a single in pediatric patients with mild asthma was associated with lower costs (US$475.51 vs. 735.33 average cost per patient) and the greatest gain in QALYs (0.9367 vs. 0.9352 QALYs on average per patient), thus leading to dominance.
Compared with the use of as-needed ICS-albuterol in separate inhalers, the use of ICS-formoterol in a single inhaler as reliever therapy is cost-effective in patients aged 12 years or more with mild asthma, because it showed a greater gain in QALYs at lower total treatment costs.
自2019年起，推荐使用单剂量吸入器按需使用低剂量吸入性糖皮质激素（ICS）-福莫特罗治疗12岁以上儿童的轻度哮喘。另外，在无法获得或负担不起ICS-福莫特罗的国家，有人提议使用ICS-沙丁胺醇。本研究的目的是评估在哥伦比亚，与单剂量吸入器中的ICS-福莫特罗相比，按需使用单独吸入器中的ICS-沙丁胺醇作为轻度哮喘儿科患者缓解治疗的成本效益。
建立了一个马尔可夫类型模型，以估计模拟的轻度哮喘儿科患者队列接受12个月治疗的成本和健康结果。有效性数据和转移概率来自相关的随机临床试验（RCT）。成本数据来自哥伦比亚卫生部提供的官方数据库。主要结果是“质量调整生命年”（QALY）变量。
基础病例分析表明，与按需使用单独吸入器中的ICS-沙丁胺醇相比，轻度哮喘儿科患者使用单剂量吸入器中的ICS-福莫特罗的成本更低（平均每位患者475.51美元对735.33美元），QALY增益最大（平均每位患者0.9367对0.9352 QALY），从而导致优势。
与按需使用单独吸入器中的ICS-沙丁胺醇相比，对于12岁及以上的轻度哮喘患者，使用单剂量吸入器中的ICS-福莫特罗作为缓解治疗具有成本效益，因为它在较低的总治疗成本下显示出更大的QALY增益。
