PHÂN TÍCH CHI PHÍ - HIỆU QUẢ CỦA ICS/FORMOTEROL SO VỚI FLUTICASONE/SALMETEROL TRONG ĐIỀU TRỊ HEN PHẾ QUẢN NGOẠI TRÚ TẠI BỆNH VIỆN QUẬN BÌNH THẠNH THÔNG QUA MÔ HÌNH MARKOV

Abstract

Objectives: Applying the Markov model to cost-effectiveness analysis of ICS/Formoterol compared with Fluticasone/Salmeterol in maintenance treatment for outpatients with mild to moderate bronchial asthma at Binh Thanh District Hospital. Research method: A probabilistic Markov model was developed including five main states: (i) successful control; (ii) sub-optimal control; (iii) non-control; (iv) severe exacerbation and (v) death. This study was implemented with a 50-years horizon with a one-week cycle from the perspective of health insurance in Vietnam. Results was expressed as an incremental cost-effectiveness ratio (ICER). Results of one-way sensitivity analysis and probabilistic sensitivity analysis. Results: Maintenance therapy with ICS/Formoterol results in additional QALY of 0.4555 years and additional expense of 31,127,095 VND (145,844,421 VND versus 114,717,326 VND, respectively).  The incremental cost-effectiveness ratio (ICER) was 68,336,103 VND/QALY, less than the willingness to pay of Vietnam in 2021 (259.164.000 VND). The results of one-way sensitivity analysis and probabilistic sensitivity analysis confirmed the robustness of the basecase results. Conclusion: From the perspective of health insurance in Vietnam, ICS/Formoterol has been considered cost-effective in the maintenance treatment of mild to moderate asthma for outpatients at Binh Thanh District Hospital