Simoens S, Laekeman G
Research Centre for Pharmaceutical Care and Pharmaco-economics, Katholieke Universiteit Leuven, Leuven, Belgium.
Allergy. 2009 Jan;64(1):85-95. doi: 10.1111/j.1398-9995.2008.01909.x. Epub 2008 Nov 28.
This article reports on a systematic literature review of the costs of allergic rhinitis (AR), the economic value of pharmacotherapy of AR, and the factors affecting costs and economic value of pharmacotherapy. Included studies had carried out a cost-of-illness analysis, cost analysis, cost-effectiveness, cost-utility or cost-benefit analysis. Allergic rhinitis imposes a substantial economic burden on society, with indirect costs of productivity loss being larger than the direct healthcare costs. Cost estimates were biased because of difficulties of diagnosis; exclusion of patients who do not seek healthcare; exclusion of over-the-counter medication; difficulties in estimating productivity loss. There is limited evidence on costs of seasonal/perennial and intermittent/persistent AR. Little is known of the economic value of pharmacotherapy of AR, although levocetirizine appears to be cost-effective as compared with placebo. Economic evaluations suffered limitations from small sample sizes, short trial duration, lack of standardized effectiveness measure, restricted scope of costs. Finally, the economic value of pharmacotherapy of AR is influenced by the perspective of the economic evaluation, relative effectiveness and costs of available drugs, patient compliance with treatment.
本文报道了一项关于变应性鼻炎（AR）成本、AR药物治疗的经济价值以及影响药物治疗成本和经济价值的因素的系统文献综述。纳入的研究进行了疾病成本分析、成本分析、成本效益分析、成本效用分析或成本效益分析。变应性鼻炎给社会带来了巨大的经济负担，生产力损失的间接成本大于直接医疗成本。由于诊断困难、排除未寻求医疗保健的患者、排除非处方药、难以估计生产力损失，成本估计存在偏差。关于季节性/常年性和间歇性/持续性AR的成本证据有限。尽管与安慰剂相比，左西替利嗪似乎具有成本效益，但对AR药物治疗的经济价值知之甚少。经济评估受到样本量小、试验持续时间短、缺乏标准化有效性测量、成本范围受限的限制。最后，AR药物治疗的经济价值受到经济评估的角度、可用药物的相对有效性和成本、患者对治疗的依从性的影响。
