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Cost-effectiveness of primary prevention of paediatric asthma: a decision-analytic model

G Feljandro P Ramos1, Antoinette D I van Asselt, Sandra Kuiper

  • 1Department of General Practice, CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands, feljandro.ramos@gmail.com.

The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care
|October 8, 2013
PubMed

Insights

Primary prevention programs for childhood asthma are feasible and cost-effective. A multifaceted approach addressing multiple environmental exposures is recommended over usual care for preventing asthma in children.

Area of Science:

  • Pediatric Allergy and Immunology
  • Public Health Interventions
  • Health Economics

Background:

  • Childhood asthma prevention is crucial for lifelong health.
  • Primary prevention strategies can be unifaceted (UF) or multifaceted (MF).
  • Assessing cost-effectiveness of prevention programs is vital for resource allocation.

Purpose of the Study:

  • To evaluate the cost-effectiveness of primary asthma prevention programs for Dutch children.
  • To compare multifaceted (MF) and unifaceted (UF) prevention strategies against usual care (UC).

Main Methods:

  • A decision-analytic tree model was developed to analyze healthcare costs and asthma cases prevented.
  • Programmes were assessed using incremental cost-effectiveness ratios (ICERs) and net monetary benefits.
  • Value-of-information analyses were conducted to address decision and parameter uncertainty.

Main Results:

  • One MF program was more effective and cost-effective than usual care (UC), with an ICER of €8,209.20 per additional asthma case prevented.
  • The MF program dominated other alternatives, indicating superior value.
  • Uncertainty in cost-effectiveness was primarily linked to probability and cost estimates for low-risk children.

Conclusions:

  • A structured MF program addressing multiple exposures (house dust mites, pet dander, environmental tobacco smoke, breastfeeding) is a feasible and cost-effective alternative to UC for primary asthma prevention.
  • This approach supports proactive strategies for reducing childhood asthma burden.
  • Further research should focus on refining estimates for low-risk populations to reduce uncertainty.
Abstract

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