Simonella L, Marks G, Sanderson K, Andrews G
School of Psychiatry, University of New South Wales. Australia.
Intern Med J. 2006 Apr;36(4):244-50. doi: 10.1111/j.1445-5994.2006.01054.x.
This article is part of a project to determine the cost-effectiveness of averting the burden of disease. We used population data to investigate the costs and benefits of allocating resources to optimal treatment for asthma in adults, using a burden of disease framework.
We calculated the population burden of asthma in the absence of any treatment as years lived with disability (YLD), ignoring the years of life lost. We then estimated the proportion of burden averted with current interventions, the proportion that could be averted with optimally implemented current evidence-based guidelines and the direct treatment cost-effectiveness ratio in dollarA per YLD averted for both current and optimal treatment.
The direct treatment cost of current treatment of adult asthma in Australia was dollar A452 million and averted 25% of the burden with a cost-effectiveness ratio of dollar A14 000/YLD averted. Optimal treatment and optimal compliance would cost dollar A627 million and avert 69% of the burden with a cost-effectiveness ratio of dollar A7000/YLD averted.
Implementation of optimal treatment for asthma is affordable, will be more cost-effective and will significantly decrease disability.
本文是确定避免疾病负担成本效益项目的一部分。我们利用人群数据，采用疾病负担框架，研究了为成人哮喘分配资源进行最佳治疗的成本和效益。
我们将未进行任何治疗时哮喘的人群负担计算为失能调整生命年（YLD），忽略了生命年损失。然后，我们估计了当前干预措施可避免的负担比例、最佳实施当前循证指南可避免的负担比例，以及当前治疗和最佳治疗每避免一个YLD以澳元计算的直接治疗成本效益比。
澳大利亚目前成人哮喘治疗的直接成本为4.52亿澳元，可避免25%的负担，成本效益比为每避免一个YLD 14000澳元。最佳治疗和最佳依从性将花费6.27亿澳元，可避免69%的负担，成本效益比为每避免一个YLD 7000澳元。
实施哮喘的最佳治疗是可承受的，将更具成本效益，并将显著减少残疾。
