PT  - JOURNAL ARTICLE
AU  - Beerthuizen, Thijs
AU  - Voorend-van Bergen, Sandra
AU  - van den Hout, Wilbert B
AU  - Vaessen-Verberne, Anja A
AU  - Brackel, Hein J
AU  - Landstra, Anneke M
AU  - van den Berg, Norbert J
AU  - de Jongste, Johan C
AU  - Merkus, Peter J
AU  - Pijnenburg, Mariëlle W
AU  - Sont, Jacob K
TI  - Cost-effectiveness of FE<sub>NO</sub>-based and web-based monitoring in paediatric asthma management: a randomised controlled trial
AID  - 10.1136/thoraxjnl-2015-207593
DP  - 2016 Jul 01
TA  - Thorax
PG  - 607--613
VI  - 71
IP  - 7
4099  - http://thorax.bmj.com/content/71/7/607.short
4100  - http://thorax.bmj.com/content/71/7/607.full
SO  - Thorax2016 Jul 01; 71
AB  - Background In children with asthma, web-based monitoring and inflammation-driven therapy may lead to improved asthma control and reduction in medications. However, the cost-effectiveness of these monitoring strategies is yet unknown.Objective We assessed the cost-effectiveness of web-based monthly monitoring and of 4-monthly monitoring of FENO as compared with standard care.Methods An economic evaluation was performed alongside a randomised controlled multicentre trial with a 1-year follow-up. Two hundred and seventy-two children with asthma, aged 4–18 years, were randomised to one of three strategies. In standard care, treatment was adapted according to Asthma Control Test (ACT) at 4-monthly visits, in the web-based strategy also according to web-ACT at 1 month intervals, and in the FENO-based strategy according to ACT and FENO at 4-monthly visits. Outcome measures were patient utilities, healthcare costs, societal costs and incremental cost per quality-adjusted life year (QALY) gained.Results No statistically significant differences were found in QALYs and costs between the three strategies. The web-based strategy had 77% chance of being most cost-effective from a healthcare perspective at a willingness to pay a generally accepted €40 000/QALY. The FENO-based strategy had 83% chance of being most cost-effective at €40 000/QALY from a societal perspective.Conclusions Economically, web-based monitoring was preferred from a healthcare perspective, while the FENO-based strategy was preferred from a societal perspective, although in QALYs and costs no statistically significant changes were found as compared with standard care. As clinical outcomes also favoured the web-based and FENO-based strategies, these strategies may be useful additions to standard care.Trial registration number Netherlands Trial Register (NTR1995).