Is bacterial lysate add-on therapy a cost-effective strategy for childhood asthma? Evidence from a Colombian economic...

Area of Science:

• Pediatric Pulmonology
• Health Economics
• Pharmacoeconomics

Background:

• Many children with asthma experience recurrent exacerbations despite standard therapy, impacting quality of life and healthcare use.
• Bacterial lysates show promise in reducing respiratory infections and asthma exacerbations, but their cost-effectiveness in low- and middle-income countries is unclear.

Purpose of the Study:

• To evaluate the cost-utility of bacterial lysate add-on therapy versus standard care for mild-to-moderate pediatric asthma in Colombia.

Main Methods:

• A probabilistic Markov decision-analytic model was used to estimate costs and quality-adjusted life years (QALYs).
• The analysis adopted a third-party payer perspective over a 1-year time horizon.
• Cost-effectiveness was assessed against a willingness-to-pay threshold of US$5,180 per QALY.

Main Results:

• Bacterial lysate add-on therapy was undominated, costing US$1,369 with an incremental cost of US$72 compared to standard care.
• It resulted in a higher utility (0.9290 vs 0.9168), yielding an incremental QALY gain of 0.0022 (approx. 0.8 quality-adjusted life days per patient/year).
• The net monetary benefit favored bacterial lysate therapy (US$3,444 vs US$3,361), with robust results across sensitivity analyses.

Conclusions:

• Bacterial lysate add-on therapy is an economically efficient adjunct strategy for pediatric asthma in resource-constrained settings.
• The therapy demonstrates a high probability of cost-effectiveness, despite modest individual-level benefits.
• Findings are subject to model assumptions and the short-term time horizon.