Economic impact of a more extensive use of FENO testing on the Italian population with asthma
Abstract Background Asthma is a common chronic inflammatory airway affecting over 260 million people worldwide, and characterized, in the large majority of cases, by the so-called “type 2 inflammation”. Fractional exhaled nitric oxide (FENO) testing is noninvasive point-of-care tool to assess type 2...
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | Respiratory Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12931-023-02437-y |
| _version_ | 1797811337063038976 |
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| author | Carla Rognoni Carlo Milano Enrico Heffler Matteo Bonini Luisa Brussino Giovanna Elisiana Carpagnano Fabio Luigi Massimo Ricciardolo Francesco Costa Patrizio Armeni |
| author_facet | Carla Rognoni Carlo Milano Enrico Heffler Matteo Bonini Luisa Brussino Giovanna Elisiana Carpagnano Fabio Luigi Massimo Ricciardolo Francesco Costa Patrizio Armeni |
| author_sort | Carla Rognoni |
| collection | DOAJ |
| description | Abstract Background Asthma is a common chronic inflammatory airway affecting over 260 million people worldwide, and characterized, in the large majority of cases, by the so-called “type 2 inflammation”. Fractional exhaled nitric oxide (FENO) testing is noninvasive point-of-care tool to assess type 2 inflammation and therefore improve asthma management. It has been suggested to determine eligibility for a specific biologic therapy and predict likelihood to respond. The aim of this study was to estimate the overall economic impact of an extensive use of FENO testing on the Italian population with asthma, including extra costs of testing and savings generated by more appropriate prescriptions, increased adherence and lower frequency of exacerbations. Methods A cost of illness analysis was firstly performed to estimate the yearly economic burden from the National Healthcare Service (NHS) perspective in Italy of the management of asthmatic patients with standard of care (SOC) according to the application of GINA (Global Initiative for Asthma) guidelines; then, we evaluated the changes in the economic burden in patient management by introducing FENO testing into clinical practice. The cost items considered were: visits/exams, exacerbations, drugs, management of adverse events caused by short-term oral corticosteroids use. Efficacy of FeNO test and SOC is based on literature evidence. Costs refer to published data or Diagnosis Related Group/outpatient tariffs. Results Considering one asthma visit every 6 months, the total yearly cost for the management of patients with asthma in Italy is 1,599,217,876€ (409.07€ per patient), while for FENO testing strategy this figure is 1,395,029,747€ (356.84€ per patient). An increased utilization rate of FENO testing from 50 to 100% of patients may lead to savings for the NHS from about 102 to 204 million € compared to SOC. Conclusions Our study showed that FeNO testing strategy may improve the management of asthmatic patients leading to significant savings for the NHS. |
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| format | Article |
| id | doaj.art-5eef4461a9f04bbc896244d3f86184b9 |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-03-13T07:21:10Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-5eef4461a9f04bbc896244d3f86184b92023-06-04T11:36:45ZengBMCRespiratory Research1465-993X2023-06-012411810.1186/s12931-023-02437-yEconomic impact of a more extensive use of FENO testing on the Italian population with asthmaCarla Rognoni0Carlo Milano1Enrico Heffler2Matteo Bonini3Luisa Brussino4Giovanna Elisiana Carpagnano5Fabio Luigi Massimo Ricciardolo6Francesco Costa7Patrizio Armeni8Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Bocconi UniversityCentre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Bocconi UniversityPersonalized Medicine, Asthma and Allergy, IRCCS Humanitas Research HospitalDepartment of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred HeartSSDDU ImmunologiaPoliclinico di Bari, UOC di Malattie dell’Apparato Respiratorio, Università Aldo MoroDepartment of Clinical and Biological Sciences, University of TorinoCentre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Bocconi UniversityCentre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Bocconi UniversityAbstract Background Asthma is a common chronic inflammatory airway affecting over 260 million people worldwide, and characterized, in the large majority of cases, by the so-called “type 2 inflammation”. Fractional exhaled nitric oxide (FENO) testing is noninvasive point-of-care tool to assess type 2 inflammation and therefore improve asthma management. It has been suggested to determine eligibility for a specific biologic therapy and predict likelihood to respond. The aim of this study was to estimate the overall economic impact of an extensive use of FENO testing on the Italian population with asthma, including extra costs of testing and savings generated by more appropriate prescriptions, increased adherence and lower frequency of exacerbations. Methods A cost of illness analysis was firstly performed to estimate the yearly economic burden from the National Healthcare Service (NHS) perspective in Italy of the management of asthmatic patients with standard of care (SOC) according to the application of GINA (Global Initiative for Asthma) guidelines; then, we evaluated the changes in the economic burden in patient management by introducing FENO testing into clinical practice. The cost items considered were: visits/exams, exacerbations, drugs, management of adverse events caused by short-term oral corticosteroids use. Efficacy of FeNO test and SOC is based on literature evidence. Costs refer to published data or Diagnosis Related Group/outpatient tariffs. Results Considering one asthma visit every 6 months, the total yearly cost for the management of patients with asthma in Italy is 1,599,217,876€ (409.07€ per patient), while for FENO testing strategy this figure is 1,395,029,747€ (356.84€ per patient). An increased utilization rate of FENO testing from 50 to 100% of patients may lead to savings for the NHS from about 102 to 204 million € compared to SOC. Conclusions Our study showed that FeNO testing strategy may improve the management of asthmatic patients leading to significant savings for the NHS.https://doi.org/10.1186/s12931-023-02437-yFractional exhaled nitric oxide testingCost of illnessAsthmaBurden |
| spellingShingle | Carla Rognoni Carlo Milano Enrico Heffler Matteo Bonini Luisa Brussino Giovanna Elisiana Carpagnano Fabio Luigi Massimo Ricciardolo Francesco Costa Patrizio Armeni Economic impact of a more extensive use of FENO testing on the Italian population with asthma Respiratory Research Fractional exhaled nitric oxide testing Cost of illness Asthma Burden |
| title | Economic impact of a more extensive use of FENO testing on the Italian population with asthma |
| title_full | Economic impact of a more extensive use of FENO testing on the Italian population with asthma |
| title_fullStr | Economic impact of a more extensive use of FENO testing on the Italian population with asthma |
| title_full_unstemmed | Economic impact of a more extensive use of FENO testing on the Italian population with asthma |
| title_short | Economic impact of a more extensive use of FENO testing on the Italian population with asthma |
| title_sort | economic impact of a more extensive use of feno testing on the italian population with asthma |
| topic | Fractional exhaled nitric oxide testing Cost of illness Asthma Burden |
| url | https://doi.org/10.1186/s12931-023-02437-y |
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