Budget impact analysis of high-flow nasal cannula for infant bronchiolitis: the Colombian National Health System perspective

Abstract

Background

High-flow nasal cannula is a non-invasive ventilation system that was introduced as an alternative to continuous positive airway pressure), with a marked increase in its use in pediatric care settings. However, the expected budget impact of this intervention has not been explicitly estimated. This study aimed to evaluate the budget impact of the high-flow nasal cannula for acute bronchiolitis in Colombia.

Methods

A budget impact analysis was performed to evaluate the potential financial impact deriving from high-flow nasal cannula during 2020. The analysis considered a 5-year time horizon and Colombian National Health System perspective. The incremental budget impact was calculated by subtracting the cost of the new treatment, in which a high-flow nasal cannula is reimbursed, from the cost of the conventional treatment without a high-flow nasal cannula (supplemental oxygen through a nasal cannula up to a maximum of 2 liters per minute). Univariate one-way sensitivity analyses were performed.

Results

In the base-case analysis the 5-year costs associated with high-flow nasal cannula and no- high-flow nasal cannula were estimated to be US$159,585,618 and US$172,751,689 respectively, indicating savings for Colombian National Health equal to US$13,166,071 if the high-flow nasal cannula is adopted for the routine management of patients with acute bronchiolitis. This result was robust in univariate sensitivity one-way analysis.

Conclusion

High-flow nasal cannula was cost-saving in emergency settings for treating infants with acute bronchiolitis. This evidence can be used by decision-makers in our country to improve clinical practice guidelines and should be replicated to validate their results in other middle-income countries.

Keywords:

• Hypertonic solution
• Colombia
• acute bronchiolitis
• high-flow nasal cannula
• budget impact

Transparency

Declaration of funding

This work was self-funded, by the authors.

Declaration of financial/other relationships

None to declare. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All the authors (JAB) contributed in the same way from the conception of the work to the publication of results. All Authors read and approved the manuscript

Acknowledgements

None to declare.

Ethics approval and consent to participate

This study was approved by the Institutional Review Board of the University of Antioquia (2015-4690).

Data availability statement

The raw data supporting the findings can be requested at CIEMTO (http://ciemto.medicinaudea.co/)