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口服锌补充剂对哥伦比亚儿童社区获得性肺炎预防效果的经济评估:简短标题:口服锌补充剂的成本效益分析

Effects of oral zinc supplementation in the prevention of community-acquired pneumonia in colombian children: an economic evaluation : Short running title: Cost-effectiveness analysis oral zinc supplementation.

作者信息

Guerrero Patiño Diana, Canchila Mery Ann Rojano, Buendía Jefferson Antonio

机构信息

Research group in Pharmacology and Toxicology, Department of Pharmacology and Toxicology, Faculty of Medicine, University of Antioquia, Medellín, Colombia.

出版信息

BMC Public Health. 2025 Aug 15;25(1):2787. doi: 10.1186/s12889-025-24138-5.


DOI:10.1186/s12889-025-24138-5
PMID:40817085
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12355844/
Abstract

INTRODUCTION: Oral zinc supplementation is a well-known intervention, widely used to prevent infectious diseases. However, it is also necessary to demonstrate that it achieves the maximum benefit at the lowest possible cost in pneumonia in children, particularly in low- and middle-income countries. This economic evaluation aims to estimate the cost-utility and cost-effectiveness of zinc supplementation for the prevention of community-acquired pneumonia in children aged 1 to 6 years in Colombia. MATERIALS AND METHODS: Using the decision tree analysis, we estimated the expected benefits and costs of zinc supplementation versus no supplementation based on data on effectiveness and cost previously published in Colombia. The perspective of the present economic evaluation is the perspective of society with a time horizon of 1 year. RESULTS: The net monetary benefit (NMB) with oral zinc supplementation was US$ 5,063.3 (95% UI: 5,061–5,065), compared to US$ 5,062.6 (95% UI: 5,060–5,064) without supplementation. The estimated cost effectiveness ratio was U$ 4 873 per QALY and U$ 10 324 per year lived gained. In the probabilistic sensitivity analysis, oral zinc supplementation was the most cost-effective therapy in the 53.4% of replications at willingness-to-pay (WTP) of U$ 5180 values. CONCLUSION: In conclusion, oral zinc supplementation in children aged 1 to 6 years in Colombia appears to be a potentially cost-effective strategy for the prevention of community-acquired pneumonia compared to non-supplementation. These findings should be interpreted with caution given the small absolute difference in benefits and the marginal incremental net monetary benefit observed. This result becomes an input for the construction of public health policies aimed at reducing the burden of disease generated by respiratory infections in Colombia, as well as serving as an example and motivation to assess the cost and utility of these strategies in other developing and developed countries.

摘要

引言:口服补充锌是一种广为人知的干预措施,被广泛用于预防传染病。然而,有必要证明在儿童肺炎治疗中,尤其是在低收入和中等收入国家,它能以尽可能低的成本实现最大效益。这项经济评估旨在估算在哥伦比亚对1至6岁儿童补充锌以预防社区获得性肺炎的成本效益和成本效用。 材料与方法:使用决策树分析,我们根据哥伦比亚先前公布的有效性和成本数据,估算了补充锌与不补充锌的预期效益和成本。本次经济评估的视角是社会视角,时间跨度为1年。 结果:口服补充锌的净货币效益(NMB)为5063.3美元(95%不确定区间:5061 - 5065美元),不补充锌的净货币效益为5062.6美元(95%不确定区间:5060 - 5064美元)。估计的成本效益比为每获得一个质量调整生命年(QALY)4873美元,每多活一年获得10324美元。在概率敏感性分析中,在支付意愿(WTP)为5180美元时,口服补充锌在53.4%的模拟中是最具成本效益的治疗方法。 结论:总之,与不补充锌相比,在哥伦比亚对1至6岁儿童口服补充锌似乎是预防社区获得性肺炎的一种潜在具有成本效益的策略。鉴于观察到的效益绝对差异较小以及边际增量净货币效益,这些发现应谨慎解读。这一结果成为构建旨在减轻哥伦比亚呼吸道感染所产生疾病负担的公共卫生政策的一个依据,同时也为评估这些策略在其他发展中国家和发达国家的成本和效用提供了一个范例和动力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5f7/12355844/9ddc50864d02/12889_2025_24138_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5f7/12355844/64755c5f5667/12889_2025_24138_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5f7/12355844/5c40e7bb8c1a/12889_2025_24138_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5f7/12355844/40cfa569ea81/12889_2025_24138_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5f7/12355844/9ddc50864d02/12889_2025_24138_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5f7/12355844/64755c5f5667/12889_2025_24138_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5f7/12355844/5c40e7bb8c1a/12889_2025_24138_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5f7/12355844/40cfa569ea81/12889_2025_24138_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5f7/12355844/9ddc50864d02/12889_2025_24138_Fig4_HTML.jpg

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[1]
Effects of oral zinc supplementation in the prevention of community-acquired pneumonia in colombian children: an economic evaluation : Short running title: Cost-effectiveness analysis oral zinc supplementation.

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[5]
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[7]
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本文引用的文献

[1]
Use of Cost-Effectiveness Thresholds in Healthcare Public Policy: Progress and Challenges.

Appl Health Econ Health Policy. 2024-11

[2]
Determining the efficiency path to universal health coverage: cost-effectiveness thresholds for 174 countries based on growth in life expectancy and health expenditures.

Lancet Glob Health. 2023-6

[3]
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Public Health Nutr. 2022-7

[4]
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Front Nutr. 2022-2-8

[5]
Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) Statement: Updated Reporting Guidance for Health Economic Evaluations.

Value Health. 2022-1

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Expert Rev Pharmacoecon Outcomes Res. 2022-6

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Biomedica. 2021-10-15

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Adv Nutr. 2022-2-1

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How Does Cost-Effectiveness Analysis Inform Health Care Decisions?

AMA J Ethics. 2021-8-1

[10]
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Pediatr Allergy Immunol. 2021-11

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