Browsing by Author "Rodriguez-Martinez, Carlos E."

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    A cost-effectiveness threshold analysis of a multidisciplinary structured educational intervention in pediatric asthma
    (2018) Rodriguez-Martinez, Carlos E.; Sossa-Briceno, Monica P.; Castro-Rodriguez, Jose A.
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    A cost-utility analysis of single maintenance and reliever (SMART) therapy as compared to step 3 fixed-dose therapy in patients aged 12 years or more with uncontrolled asthma
    (2024) Rodriguez-Martinez, Carlos E.; Sossa-Briceno, Monica P.; Castro-Rodriguez, Jose A.
    ObjectivesA significant percentage of patients with asthma appear to benefit from the addition of long-acting beta 2-agonists (LABAs) to ICS to achieve better control of their disease. The aim of the present study was to determine the cost-utility of single inhaler combination inhaled ICS/LABAs as both maintenance and reliever (SMART) versus remaining at the same treatment step with fixed-dose ICS-LABA maintenance with a short-acting beta 2-agonist (SABA) as reliever in patients aged 12 years or more with uncontrolled asthma.MethodsA Markov-type model was developed to estimate the costs and health outcomes of a simulated cohort of patients aged 12 years or more with uncontrolled asthma treated for 12 months. The effectiveness data and transition probabilities were obtained from a recent meta-analysis. Cost data were obtained from official databases provided by the Colombian Ministry of Health. The main outcome was the variable "quality-adjusted life-years" (QALYs).ResultsThe base-case analysis showed that compared with remaining at the same GINA treatment step with ICS/LABA maintenance plus SABA reliever, ICS/LABAs as SMART was associated with lower costs, US$2,906.92 versus $4,462.02 average cost per patient, and the greatest gain in QALYs, 0.8540 versus 0.8258 QALYs on average per patient, thus leading to dominance.ConclusionsCompared with remaining at the same GINA treatment step with ICS/LABA maintenance plus SABA reliever, ICS/LABAs as SMART is more cost-effective in patients aged 12 years or more with uncontrolled asthma. This is because ICS/LABAs as SMART showed a greater gain in QALYs at lower total treatment costs.
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    Comparison of the bronchodilating effects of albuterol delivered by valved vs. non-valved spacers in pediatric asthma
    (2012) Rodriguez-Martinez, Carlos E.; Sossa-Briceño, Monica P.; Castro Rodríguez, José Antonio
    Introduction: Inhaled therapy using a metered-dose inhaler (MDI) with attachedvalved holding chamber has been increasingly recognized as the optimal method fordelivering bronchodilators for asthma treatment. However, mainly due to the highcost of these valved holding chambers in many developing countries, the use of non-valved spacers is frequent, despite the scarce evidence that supports their efficacy. Theaim of this study was to compare the bronchodilator response to albuteroladministered by MDI with and without a valved spacer.Methods: In a randomized, two-period, two-sequence crossover clinical trial, weanalyzed 31 stable asthmatic children (6–18 yrs of age) on two consecutive days, whowere randomly assigned to receive 100 lg of albuterol MDI through either a locallyproduced valved spacer or a non-valved spacer. The next day, a crossover treatmentwas employed through the use of the other spacer. Spirometry was recorded beforeand after each albuterol administration.Results: As we were not able to identify any sequence or carryover effect, we tested fortreatment effects in both periods. No significant differences in the absolute change inFEV1(0.20 ± 0.17 vs. 0.18 ± 0.16, p = 0.63), FVC (0.07 ± 0.13 vs. 0.07 ± 0.16,p = 0.88), or MMEF (0.49 ± 0.31 vs. 0.43 ± 0.39, p = 0.53) after bronchodilatoradministration were found between the use of valved and non-valved spacers.Conclusions: In stable asthmatic children, albuterol administered through MDI usinga non-valved spacer produces a bronchodilator response similar to that of a spacerwith a valve that requires an inhalatory opening pressure (with flows between 2 and32 l/min) that even toddlers with bronchial obstruction can easily generate.
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    Cost Effectiveness of Pharmacological Treatments for Asthma: A Systematic Review
    (2018) Rodriguez-Martinez, Carlos E.; Sossa-Briceno, Monica P.; Castro-Rodriguez, Jose A.
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    Cost-utility analysis of daily versus intermittent inhaled corticosteroids in mild-persistent asthma
    (2015) Rodriguez-Martinez, Carlos E.; Nino, Gustavo; Castro Rodríguez, José Antonio
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    Single inhaler combination inhaled corticosteroid-formoterol as both maintenance and reliever (SMART) compared with a step up of treatment with fixed-dose inhaled corticosteroid-long-acting β2-agonist maintenance with a short-acting β2-agonist as reliever in adolescents and adults with poorly controlled asthma in Colombia: a cost-utility analysis
    (2024) Rodriguez-Martinez, Carlos E.; Sossa-Briceno, Monica P.; Castro-Rodriguez, Jose A.
    ObjectiveThe aim of the present study was to determine the cost-utility of single inhaler combination inhaled corticosteroid and a long-acting beta 2-agonist (ICS/LABAs) as both maintenance and reliever (SMART) compared with a step-up maintenance treatment with a fixed medium to high dose of ICS combined with LABA and a short-acting beta 2-agonist (SABA) as reliever (ICS-LABA maintenance plus SABA) among patients aged 12 years or more with poorly controlled asthma in Colombia.MethodsA Markov-type model was developed to estimate the costs and health outcomes of a simulated cohort of patients aged 12 years or more with uncontrolled asthma treated for 12 months. The main effectiveness data were obtained from a recent meta-analysis. The main outcome was the variable ''quality-adjusted life-years'' (QALYs).ResultsThe base-case analysis showed that the budesonide/formoterol (BUD/FORM) SMART strategy was associated with lower overall treatment costs (US $3,062.37 vs. $4,462.02 average cost per patient over 12 months) and the greatest gain in QALYs (0.8511 vs. 0.8258 QALYs on average per patient over 12 months) compared with ICS-LABA maintenance plus SABA at step 4, thus leading to dominance.ConclusionsIn patients aged 12 years or more with uncontrolled asthma at GINA step 3 or 4, the BUD/FORM SMART strategy at either step 3 or 4 is cost-effective compared with the ICS-LABA maintenance plus SABA at step 4 strategy, because it shows a greater gain in QALYs at lower total treatment costs.
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    The relationship between inflammation and remodeling in childhood asthma: A systematic review
    (2018) Castro-Rodriguez, Jose A.; Saglani, Sejal; Rodriguez-Martinez, Carlos E.; Oyarzun, Maria A.; Fleming, Louis; Bush, Andrew