BioMedEcon LLC, Moss Beach, California 94038, USA.
Ann Allergy Asthma Immunol. 2010 Jan;104(1):79-85. doi: 10.1016/j.anai.2009.11.010.
Children with allergic rhinitis (AR) often experience significant impairment in quality of life and health, which increases health care utilization.
To determine whether allergen immunotherapy reduces health care utilization and costs in children newly diagnosed as having AR using a retrospective matched cohort design.
Among children (age <18 years) with a Florida Medicaid paid claim between 1997 and 2007, immunotherapy-treated patients were selected who had newly diagnosed AR, who had not received immunotherapy before their first (index) AR diagnosis, who had received at least 2 immunotherapy administrations after their index AR diagnosis, and who had at least 18 months of data after their first immunotherapy administration. A control group of patients with newly diagnosed AR who had not received immunotherapy either before or subsequent to their index AR diagnosis also were identified, and up to 5 were matched with each immunotherapy-treated patient by age at first AR diagnosis, sex, race/ethnicity, and diagnosis of asthma, conjunctivitis, or atopic dermatitis.
Immunotherapy-treated patients had significantly lower 18-month median per-patient total health care costs ($3,247 vs $4,872), outpatient costs exclusive of immunotherapy-related care ($1,107 vs $2,626), and pharmacy costs ($1,108 vs $1,316) compared with matched controls (P < .001 for all). The significant difference in total health care costs was evident 3 months after initiating immunotherapy and increased through study end.
This study demonstrates the potential for early and significant cost savings in children with AR treated with immunotherapy. Greater use of this treatment in children could significantly reduce AR-related morbidity and its economic burden.
患有过敏性鼻炎（AR）的儿童常经历生活质量和健康的显著受损，这增加了医疗保健的利用。
使用回顾性匹配队列设计确定变应原免疫疗法是否降低新诊断为 AR 的儿童的医疗保健利用和成本。
在 1997 年至 2007 年期间佛罗里达州医疗补助计划支付索赔的儿童（年龄<18 岁）中，选择接受免疫治疗的患者，这些患者具有新诊断的 AR，在其首次（索引）AR 诊断之前未接受免疫治疗，在其索引 AR 诊断后接受了至少 2 次免疫治疗，并且在其首次免疫治疗后至少有 18 个月的数据。还确定了未在索引 AR 诊断之前或之后接受免疫治疗的新诊断 AR 患者的对照组，并且为每个免疫治疗患者匹配了最多 5 名年龄、性别、种族/族裔和诊断为哮喘、结膜炎或特应性皮炎的患者。
免疫治疗患者在 18 个月的中位每位患者总医疗保健费用（$3247 与$4872）、免疫治疗相关护理以外的门诊费用（$1107 与$2626）和药房费用（$1108 与$1316）均显著低于匹配对照组（所有 P<0.001）。在开始免疫治疗后 3 个月就出现了总医疗保健费用的显著差异，并在研究结束时增加。
本研究表明，接受免疫治疗的 AR 儿童具有早期和显著节省成本的潜力。在儿童中更广泛地使用这种治疗方法可以显著降低 AR 相关发病率及其经济负担。
