Figures
- FIGURE 1
Schematic diagram of the model. GA: genetic abnormality.
- FIGURE 2
Cost-effectiveness acceptability curve comparing no intervention with targeted intervention.
- FIGURE 3
Scenario analysis (tornado diagram). ICER: incremental cost-effectiveness ratio; QALY: quality-adjusted life-year.
Tables
- TABLE 1
Model inputs
Parameter Mean Distribution Reference Probabilities Prevalence of asthma 323 500 Fixed [19] Percentage of mild asthma 67.1% Fixed [4] Prevalence of genetic abnormality (GSTT1 null, GSTM1 null or GSTP1 Ile105) 25% Fixed [20, 21] Risk of additional exacerbation in asthmatics with genetic abnormality, without preventive intervention 55% Beta (42.7, 34.9) [22, 23] Risk of additional exacerbation in asthmatics with genetic abnormality, with preventive intervention 5% Beta (91.2,1732.5) [22, 23] Risk of additional exacerbation in asthmatics without genetic abnormality (with or without preventive intervention) 0 Fixed Unit costs Advair 500/50 twice per day (per month) $74.7 Fixed [19] Exacerbation without hospitalisation $126 Gamma (96.04,0.76) [24]
(Converted to 2018 CAD)Exacerbation requiring emergency room visits $575 Gamma (96,0.17) [24]
(Converted to 2018 CAD)Exacerbation requiring hospitalisations $6440 Gamma (96,0.014) [24]
(Converted to 2018 CAD)Genetic testing 109.43 Fixed [25]
(Converted to 2018 CAD)Utilities Exacerbation without hospitalisation 0.57 Beta (0.51, 0.38) [26] Exacerbation requiring emergency room visits 0.45 Beta (0.36, 0.45) [26] Exacerbation requiring hospitalisations 0.33 Beta (0.15, 0.30) [26] CAD: Canadian dollars.
- TABLE 2
The expected value of costs, QALY and incremental cost per QALY (base case) per one patient with mild asthma
Strategy Costs ($) QALY loss Sequential incremental costs Sequential incremental QALY loss Sequential incremental cost per QALY Gained No intervention 42.13 0.0024 Preventive intervention only for asthmatics with genetic abnormality 150.58 0.00021 108.45 −0.00219 $49 555 Preventive intervention for all asthmatics 153.2 0.00021 2.61 0 Dominated QALY: quality-adjusted life-year. All the numbers are per asthmatic.
Supplementary Material
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Supplementary material 00790-2020.SUPPLEMENT
Vol 7 Issue 1
Table of Contents
The economics of precision health: preventing air pollution-induced exacerbation in asthma
