The cost-utility of intravenous magnesium sulfate for treating asthma exacerbations in children

Pediatr Pulmonol. 2020 Oct;55(10):2610-2616. doi: 10.1002/ppul.25024. Epub 2020 Aug 22.

Abstract

Introduction: Although evidence supports the use of intravenous magnesium sulfate (MS) in asthma exacerbations, MS continues to be considered a second-line drug for managing pediatric asthma exacerbations. This study aimed to evaluate the cost-utility of MS in asthma exacerbations.

Methods: We used a decision tree model to estimate the cost-utility of MS compared to treatment without MS (control group) in children with asthma exacerbations. Cost data were obtained from a retrospective study from tertiary centers in Rionegro, Colombia, while utilities were collected from the literature. Probabilistic sensitivity analysis was carried out using the Monte Carlo technique with a simulation of a hypothetical cohort of 10 000 patients to generate expected cost utilities with 95% confidence intervals. We used a cost-effectiveness acceptability curve to evaluate the uncertainty surrounding the cost-utility of MS.

Results: The model showed that MS had a lower total cost than the control group (US $1149 vs US $1598 average cost per patient) and higher quality-adjusted life years (0.60 vs 0.52 average per patient), showing dominance. The probability that MS provides a more cost-effective use of resources compared with standard therapy exceeds 99% for all willingness-to-pay thresholds.

Conclusion: Intravenous MS was less expensive and more effective than treatment without intravenous MS in children with asthma exacerbations. Our study provides evidence that should be used by decision-makers to improve clinical practice guidelines and should be replicated to validate its results in other middle-income countries.

Keywords: health care; health economics; public health.

MeSH terms

  • Administration, Intravenous
  • Adolescent
  • Asthma / drug therapy*
  • Asthma / economics*
  • Bronchodilator Agents / economics*
  • Bronchodilator Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Colombia
  • Cost-Benefit Analysis
  • Decision Trees
  • Disease Progression
  • Female
  • Humans
  • Magnesium Sulfate / economics*
  • Magnesium Sulfate / therapeutic use*
  • Male
  • Retrospective Studies
  • Tertiary Care Centers

Substances

  • Bronchodilator Agents
  • Magnesium Sulfate