A cost-utility analysis of single maintenance and reliever (SMART) therapy as compared to step 3 fixed-dose therapy in patients aged 12 years or more with uncontrolled asthma

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dc.contributor.authorRodriguez-Martinez, Carlos E.
dc.contributor.authorSossa-Briceno, Monica P.
dc.contributor.authorCastro-Rodriguez, Jose A.
dc.date.accessioned2025-01-20T16:05:20Z
dc.date.available2025-01-20T16:05:20Z
dc.date.issued2024
dc.description.abstractObjectivesA significant percentage of patients with asthma appear to benefit from the addition of long-acting beta 2-agonists (LABAs) to ICS to achieve better control of their disease. The aim of the present study was to determine the cost-utility of single inhaler combination inhaled ICS/LABAs as both maintenance and reliever (SMART) versus remaining at the same treatment step with fixed-dose ICS-LABA maintenance with a short-acting beta 2-agonist (SABA) as reliever in patients aged 12 years or more with uncontrolled asthma.MethodsA Markov-type model was developed to estimate the costs and health outcomes of a simulated cohort of patients aged 12 years or more with uncontrolled asthma treated for 12 months. The effectiveness data and transition probabilities were obtained from a recent meta-analysis. 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).ResultsThe base-case analysis showed that compared with remaining at the same GINA treatment step with ICS/LABA maintenance plus SABA reliever, ICS/LABAs as SMART was associated with lower costs, US$2,906.92 versus $4,462.02 average cost per patient, and the greatest gain in QALYs, 0.8540 versus 0.8258 QALYs on average per patient, thus leading to dominance.ConclusionsCompared with remaining at the same GINA treatment step with ICS/LABA maintenance plus SABA reliever, ICS/LABAs as SMART is more cost-effective in patients aged 12 years or more with uncontrolled asthma. This is because ICS/LABAs as SMART showed a greater gain in QALYs at lower total treatment costs.
dc.fuente.origenWOS
dc.identifier.doi10.1002/ppul.27328
dc.identifier.eissn1099-0496
dc.identifier.issn8755-6863
dc.identifier.urihttps://doi.org/10.1002/ppul.27328
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/89895
dc.identifier.wosidWOS:001339781800001
dc.language.isoen
dc.revistaPediatric pulmonology
dc.rightsacceso restringido
dc.subjectcombination of corticosteroid and long-acting beta 2 agonists
dc.subjectcost-effectiveness
dc.subjectpersistent asthma
dc.subjectquality-adjusted life-years
dc.subjectsMART therapy
dc.titleA cost-utility analysis of single maintenance and reliever (SMART) therapy as compared to step 3 fixed-dose therapy in patients aged 12 years or more with uncontrolled asthma
dc.typeartículo
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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