Frati F, Ariano R, Cadario G, Ortolani C, Passalacqua G
Istituto di Pediatria, Dipartimento di Specialità Medicochirurgiche e Sanità Pubblica, Università di Perugia, Italy.
Eur Ann Allergy Clin Immunol. 2007;39 Spec No:4-6.
The increasing development of new health care technologies, along with the ageing of the population and the increasing patients' expectations, cause a significant raise in medical costs, inducing in policy makers the need for well-funded information to support their decisions. The development of Health Technology Assessment (HTA), which is the systematic evaluation of properties, effects or other impacts of health technology and can be considered as a bridge between the world of research and the world of policy-making, reflects this high level of demand. HTA requires a multidisciplinary approach, that covers many different disciplines, in order to assess various aspects of health technologies, as technical properties, safety, efficacy/effectiveness, economic aspects, social, legal, ethical and political impacts. Allergic diseases show a worldwide increasing prevalence and consequent increasing costs, which result very high in recent evaluations. Specific immunotherapy is the only treatment able to alter, differently from drugs, the natural course of allergic diseases, exerting a long-lasting therapeutic effect, that persists also after stopping the therapy. This has a potential great impact in the cost of disease, which only recently was considered in properly designed studies. These issues claim for a larger use of HTA, which may provide a more comprehensive approach to the evaluation of the impact of immunotherapy on allergic patients.
新的医疗保健技术不断发展，加之人口老龄化以及患者期望的提高，导致医疗成本大幅上升，这使得政策制定者需要有充足资金支持的信息来辅助决策。卫生技术评估（HTA）的发展反映了这种高度需求，HTA是对卫生技术的特性、效果或其他影响进行系统评估，可被视为研究领域与政策制定领域之间的一座桥梁。HTA需要采用多学科方法，涵盖许多不同学科，以便评估卫生技术的各个方面，如技术特性、安全性、疗效/有效性、经济方面、社会、法律、伦理和政治影响。过敏性疾病在全球范围内的患病率不断上升，随之而来的是成本增加，在最近的评估中成本非常高。特异性免疫疗法是唯一一种能够不同于药物改变过敏性疾病自然病程的治疗方法，具有持久的治疗效果，即使在停止治疗后仍能持续。这对疾病成本可能产生巨大影响，而直到最近在精心设计的研究中才对此进行考虑。这些问题要求更广泛地使用HTA，HTA可为评估免疫疗法对过敏性患者的影响提供更全面的方法。
