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

2020 ◽  
pp. 1-7
Author(s):  
Jefferson Antonio Buendía ◽  
Hernan Lucio Talamoni
Keyword(s):  
Cost Utility ◽  
Sputum Eosinophil ◽  
Children With Asthma ◽  
Eosinophil Counts

scholarly journals Use of sputum eosinophil counts to guide management in children with severe asthma

Thorax ◽  
2012 ◽  
Vol 67 (11) ◽  
pp. 1015.1-1016 ◽  
Author(s):  
Louise Fleming ◽  
Andrew Bush
Keyword(s):  
Severe Asthma ◽  
Sputum Eosinophil ◽  
Eosinophil Counts

scholarly journals A Pharmaco-Economic Analyzis of Treating Severe Uncontrolled Child Asthma with Omalizumab — Actual Russian Clinical Practice Data

2016 ◽  
Vol 13 (4) ◽  
pp. 345-353
Author(s):  
A. S. Kolbin ◽  
L. S. Namazova-Baranova ◽  
E. A. Vishneva ◽  
M. Y. Frolov ◽  
T. L. Galankin ◽  
...  
Keyword(s):  
Cost Efficiency ◽  
High Efficiency ◽  
Planning Horizon ◽  
Cost Utility ◽  
Atopic Asthma ◽  
Quality Life ◽  
Children With Asthma ◽  
The Stability ◽  
The Cost ◽  
Economic Expediency

Background:Omalizumab is the first and yet the only biopreparation for asthma which combines high efficiency and high cost. The clinical-economic expediency of using omalizumab in asthmatic children has not been previously studied in Russia.Objective:Our aim was to evaluate the clinical and economic expediency of using omalizumab as additive treatment (to basic or supporting therapy) in children with severe uncontrolled atopic asthma under the Russian economic conditions.Methods:We conducted a mathematical simulation of asthma treatment in children with an increased frequency of hospitalization (9 times per year) with an average monthly omalizumab requirement of 558 mg. The model is based on the Markov chain. The model includes direct and non-direct costs. The planning horizons were 2 and 5 years. We analyzed the efficiency and utility of the costs and their influence on the budget. The stability of received data is proven by sensitivity analyzis.Results:Over a 5-year planning horizon the cost of an additional year of quality life (due to using omalizumab) was 1,259,185 roubles, while the “society’s solvency” is 1 341 308 roubles (cost utility analizis). It takes 39,820 rubles to prevent one hospitalization with omalizumab over a 5-year planning horizon (cost efficiency analizis), which is comparable to the cost of hospitalization (43,141 rubles). Total costs for treating 100 children with asthma, 7 of which would be treated with omalizumab, were equal to the amount of money which is enough to treat 105 children without omalizumab (analysis of budgetary influence).Conclusion:The analyses of cost efficiency and utility have shown that the strategy of using omalizumab together with standard treatment is economically expedient. Budgetary influence analysis has not detected a significant burden on the budget.

Cost‐utility analysis of an integrated care program for children with asthma in a medium‐income country

2020 ◽  
Vol 55 (11) ◽  
pp. 3110-3118
Author(s):  
Elida Duenas‐Meza ◽  
Luis F. Giraldo‐Cadavid ◽  
Elizabeth Karpf ◽  
Felipe Afanador ◽  
Olga L. Angarita ◽  
...  
Keyword(s):  
Integrated Care ◽  
Care Program ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Income Country ◽  
Utility Analysis ◽  
Children With Asthma

Asthma exacerbations and sputum eosinophil counts

The Lancet ◽  
2003 ◽  
Vol 361 (9365) ◽  
pp. 1302-1303 ◽  
Author(s):  
Graeme P Currie ◽  
Daniel KC Lee ◽  
Brian J Lipworth
Keyword(s):  
Sputum Eosinophil ◽  
Asthma Exacerbations ◽  
Eosinophil Counts

scholarly journals Efficacy of inhaled corticosteroids for patients with asthma: a descriptive review of randomized controlled trials

2015 ◽  
Vol 5 (1) ◽  
pp. 41-50
Author(s):  
Mostafa Alabousi ◽  
Abdullah Alabousi ◽  
Natalie Ambeault ◽  
John Riva
Keyword(s):  
Fluticasone Propionate ◽  
Full Text ◽  
Beclomethasone Dipropionate ◽  
Search Strategy ◽  
Inhaled Corticosteroids ◽  
Controlled Trials ◽  
Sputum Eosinophil ◽  
Randomized Controlled ◽  
Eosinophil Counts ◽  
Full Text Screening

Objective: To evaluate the efficacy of inhaled corticosteroids (ICS) in patients with asthma based on changes in sputum eosinophil counts, through a review of relevant randomized controlled trials (RCTs).Methods: Studies were retrieved from MEDLINE, EMBASE, the SYSTEM FOR INFORMATION ON GREY LITERATURE, and the INSTITUTE FOR SCIENTIFIC INFORMATION from February 1, 2003 to February 1, 2013 based on a comprehensive search strategy. Articles were screened through two stages: title and abstract; and full-text screening. RCTs enrolling patients with asthma, testing an ICS intervention, and reporting outcomes on changes in sputum eosinophil counts pre- and post-intervention were included. Following screening, data extraction, and quality appraisal, a descriptive synthesis of trials was conducted.Results: The search strategy retrieved 447 articles, of which 66 articles underwent full-text screening, resulting in 37 RCTs that met the inclusion criteria for this review. The articles were stratified according to the type of ICS: budesonide, fluticasone propionate, ciclesonide, beclomethasone dipropionate, and mometasone.  Across trials, 9 of 16 budesonide, 5 of 14 fluticasone propionate, 4 of 9 of nine ciclesonide, 2 of 4 beclomethasone dipropionate, and 1 of 2 mometasone interventions demonstrated a statistically significant (p < 0.05) reduction in sputum eosinophil counts.Conclusion: This study detected differences between ICS treatments however the clinical relevance is uncertain. There is insufficient evidence to suggest the superiority of one ICS treatment over another. Further research needs to be conducted to evaluate the relative impact of ICS products upon eosinophil counts, as well as in clarifying what quantitative level of change in baseline eosinophil counts is required to observe a change in symptom improvement and disease control.

Asthma exacerbations and sputum eosinophil counts

The Lancet ◽  
2003 ◽  
Vol 361 (9365) ◽  
pp. 1303 ◽  
Author(s):  
Ruth H Green ◽  
Christopher E Brightling ◽  
Andrew J Wardlaw ◽  
Ian D Pavord
Keyword(s):  
Sputum Eosinophil ◽  
Asthma Exacerbations ◽  
Eosinophil Counts

scholarly journals Serum Prednisolone Levels as a Marker of Oral Corticosteroid Adherence in Severe Asthma

2020 ◽  
Author(s):  
James Michael Ramsahai ◽  
Emily King ◽  
Robert Niven ◽  
Gael Tavernier ◽  
Peter Wark ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Prospective Observational Study ◽  
Oral Prednisolone ◽  
Sputum Eosinophil ◽  
Steroid Resistant ◽  
Sputum Eosinophilia ◽  
Advanced Therapies ◽  
Objective Marker ◽  
Eosinophil Counts

Abstract Background Severe asthma is a complex heterogeneous disease typically requiring advanced therapies. Underlying the treatment of all asthma, however, is the consistent recommendation across international guidelines to ensure that adherence to therapy is adequate. Currently, there is no consensus on an objective marker of adherence.Methods We performed a prospective observational study of 17 participants taking oral prednisolone using serum prednisolone levels as a marker of adherence, and sputum eosinophilia as a marker of control of type 2 airway inflammation. Based on these biomarkers, we classified participants into a non-adherent and an adherent cohort, and further stratified by the presence of ongoing sputum eosinophilia.Results We identified 3 non-adherent participants and 14 who were adherent, based on their serum prednisolone levels. Stratification using sputum eosinophil counts identified one participant as having ongoing sputum eosinophilia in the setting of non-adherence, while six were identified as steroid resistant with ongoing sputum eosinophilia despite adherence to oral prednisolone therapy.Conclusion Serum prednisolone can be used an objective marker of adherence in those patients with severe asthma taking daily oral prednisolone. In combination with sputum eosinophil counts, a steroid resistant cohort can be distinguished from one with ongoing inflammation in the setting of non-adherence. This information can then be used by clinicians to differentiate the optimal next steps for treatment in these specific populations.

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