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

INTRODUCTION: Despite optimized standard therapy, many children with asthma continue to experience recurrent exacerbations. Bacterial lysates have demonstrated clinical benefits in reducing respiratory infections and asthma exacerbations, but their economic value in low- and middle-income countries remains uncertain. This study evaluated the cost-utility of bacterial lysate add-on therapy compared with standard care in children with mild-to-moderate asthma in Colombia. METHODS: A probabilistic Markov decision-analytic model was developed to estimate costs and quality-adjusted life years (QALYs) from a third-payer perspective over a 1-year time horizon. Cost-effectiveness was assessed using a willingness-to-pay threshold of US$5,180 per QALY gained. RESULTS: Bacterial lysate add-on therapy was undominated, with a total cost of US$1,369 and an incremental cost of US$72 compared with standard care. The net monetary benefit was US$3,444 for bacterial lysate add-on therapy versus US$3,361 for standard care. CONCLUSIONS: From a probabilistic economic perspective, bacterial lysate add-on therapy appears to be an economically efficient adjunct strategy, with modest individual-level benefits but a high probability of cost-effectiveness within resource-constrained healthcare settings. These findings should be interpreted in the context of model assumptions and the short-term time horizon.