Cost-effectiveness analysis of pharmaceutical care in the management of pediatric asthma in China

Pediatric asthma is a non-communicable disease with a significant burden, and many patients cannot receive early diagnosis and effective control of the disease. Exploring the role of pharmacists in the management of pediatric asthma can provide possibilities for improving the management of pediatric asthma. The purpose of this simulation study is to quantify the 12-month disease burden reduction of pediatric asthma under pharmacist-led pharmaceutical care using QALY metrics, and to further estimate the short-term cost-effectiveness of pharmacist-led pharmaceutical care within a one-year time horizon. From a payer perspective, a Markov model was developed using cohort simulation to simulate 2 contrasting scenarios regarding to pediatric asthma management in China: the status quo scenario, and a pharmaceutical care scenario based on providing pharmaceutical care to all pediatric asthma patients. The model cycle length was one month and simulated a one-year time range. The results of the model were the direct medical expenses and quality adjusted life years associated with pediatric asthma. Both deterministic sensitivity analysis and probabilistic sensitivity analysis were conducted to test the robustness of the results. For the status quo scenario, the calculated total cost and QALYs were CNY 1300.6 and 10.8, respectively. The corresponding values for the pharmaceutical care scenario were CNY 1324.8 and 11.2. Compared with the status quo scenario, the pharmaceutical care scenario increased the cost by CNY 60.3 for every additional unit of QALY obtained. Therefore, for the WTP thresholds of CNY 89,358/QALY, the pharmaceutical care scenario was less than the thresholds and was cost-effective. Both deterministic and probabilistic sensitivity analyses demonstrated that the pharmaceutical care scenario was always more cost-effective than the status quo scenario. Expanding the scope of pharmacist services has a significant return on investment for pediatric asthma management. This study has several data and modeling limitations stemming from insufficient real-world evidence, and further comprehensive real-world research is needed to validate our findings.