Cost-utility of use of sputum eosinophil counts to guide management in children with asthma

Abstract

Background

Tailoring asthma interventions based on sputum eosinophils are beneficial in reducing the frequency of asthma exacerbations. The routine use of sputum eosinophils in asthma in children is not uniformly adopted. The main barriers to policymakers adopting new technologies are always doubts about their cost-utility in scenarios with scarce health resources. This study aimed to evaluate the cost-utility of sputum eosinophil counts to guide management in children with asthma, from a societal perspective.

Methods

A Markov simulation with three mutually exclusive nonabsorbent states was used. The intervention evaluated was adjustment of asthma therapy based on sputum eosinophils to adjusting therapy based on clinical symptoms with or without spirometry/peak flow in children between 4 and 18 years of age (EO). The group comparison was adjusting therapy based on clinical symptoms with or without spirometry/peak flow (SC). The analysis was carried out from a societal perspective. The analytic horizon was 12 months

Results

The model showed that EO was associated with lower cost than SC (US $1375 vs US $1454 average annual cost per patient), and higher QALYs (0.95 vs 0.92 average per patient); showing dominance. The probability that EO provides a more cost-effective use of resources compared with standard therapy exceeds 99% for all willingness to pay thresholds

Conclusion

EO was cost-effective for infants with asthma to guide asthma management in Children. Our study provides evidence that should be used by decision-makers to improve clinical practice guidelines and should be replicated to validate their results in other middle-income countries.

KEYWORDS:

• Health economics
• public health
• healthcare

Data availability statement

All data can be request to [email protected].

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

This work was funding with owner funds of authors.