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Cost-effectiveness and Budget Impact of Routine Use of Fractional Exhaled Nitric Oxide Monitoring for the Management of Adult Asthma Patients in Spain

Lorenzo Sabatelli1, Ulla Seppälä2, Joaquin Sastre3, Glenn Crater4

1GLOBMOD Health, Barcelona, Spain
2Medical Affairs, Aerocrine AB, Solna, Sweden
3Hospital Universitario Fundación Jiménez Díaz, Avda. Reyes Católicos, 2, 28040 Madrid, Spain
4Global Clinical Development & Medical Affairs, Morrisville, NC, USA

J Investig Allergol Clin Immunol 2017; Vol. 27(2)
doi: 10.18176/jiaci.0103

Objectives: Fractional exhaled nitric oxide (FeNO) is a marker for Type-2 airway inflammation. The objective of this study was to evaluate cost-effectiveness and budget impact of FeNO monitoring for management of adult asthma in Spain.
Methods: Cost-effectiveness model analysis was used to evaluate the economic outcomes when asthma management was assisted with FeNO monitoring. Over a one-year period, the model estimated the incremental cost per quality-adjusted life year (QALY) and incremental number of exacerbations avoided when FeNO monitoring was added to standard guideline-driven asthma care and compared to standard care alone. Univariate and multivariate sensitivity analyses explored uncertainty in the model. A budget impact model was used to examine the financial impact of FeNO assisted monitoring on the primary care settings across the Spanish health system.
Results: The results showed that adding FeNO to standard asthma care saved €62.53 per patient per year in the adult population, and improved QALYs by 0.026 per patient per year. The budget impact analysis demonstrated an estimated €129 million net yearly saving if FeNO assisted monitoring was used in primary care settings in Spain.
Conclusions: The present economic model shows that adding FeNO to the treatment algorithm can save considerable economic resources and increase quality of life when used to manage asthma in combination with current treatment guidelines.

Key words: Asthma management, Biomarker, Budget impact, Cost effectiveness, FeNO, Guidelines, Exhaled nitric oxide.