Brodtkorb Thor-Henrik, Zetterström Olle, Tinghög Gustav
Center for Medical Technology Assessment, Department of Medical and Health Sciences, Linköpings Universitet, Linköping, Sweden.
Clin Respir J. 2010 Apr;4(2):104-10. doi: 10.1111/j.1752-699X.2009.00156.x.
Airsonett Airshower (AA) is a novel non-pharmaceutical treatment for patients with perennial allergic asthma that uses a laminar airflow directed to the breathing zone of patients during sleep. It has been shown that AA treatment in addition to optimized standard therapy significantly increases asthma-related quality of life among adolescent asthmatics. However, the cost-effectiveness of AA treatment has not yet been assessed. As reimbursement decisions are increasingly guided by results from the cost-effectiveness analysis, such information is valuable for health-care policy-makers.
The objective of this study was to estimate the cost-effectiveness of adding AA treatment with allergen-free air during night sleep to optimized standard therapy for adolescents with perennial allergic asthma compared with placebo.
A probabilistic Markov model was developed to estimate costs and health outcomes over a 5-year period. Costs and effects are presented from a Swedish health-care perspective (QALYs). The main outcome of interest was cost per QALY gained.
The Airshower strategy resulted in a mean gain of 0.25 QALYs per patient, thus yielding a cost per QALY gained of under euro35 000 as long as the cost of Airshower is below euro8200.
Adding AA treatment to optimized standard therapy for adolescents with perennial allergic asthma compared with placebo is generating additional QALYs at a reasonable cost. However, further studies taking more detailed resource use and events such as exacerbations into account would be needed to fully evaluate the cost-effectiveness of AA treatment.
Airsonett空气淋浴器（AA）是一种针对常年性过敏性哮喘患者的新型非药物治疗方法，它在患者睡眠期间向其呼吸区域输送层流空气。研究表明，在优化的标准治疗基础上进行AA治疗，可显著提高青少年哮喘患者与哮喘相关的生活质量。然而，AA治疗的成本效益尚未得到评估。由于报销决策越来越多地受到成本效益分析结果的指导，此类信息对医疗保健政策制定者具有重要价值。
本研究的目的是评估在夜间睡眠时添加无过敏原空气的AA治疗与安慰剂相比，对常年性过敏性哮喘青少年患者进行优化标准治疗的成本效益。
建立了一个概率马尔可夫模型，以估计5年内的成本和健康结果。成本和效果从瑞典医疗保健的角度（质量调整生命年）进行呈现。主要关注的结果是每获得一个质量调整生命年的成本。
空气淋浴策略使每位患者平均获得0.25个质量调整生命年，因此只要空气淋浴的成本低于8200欧元，每获得一个质量调整生命年的成本就低于35000欧元。
与安慰剂相比，在常年性过敏性哮喘青少年患者的优化标准治疗中添加AA治疗，能以合理的成本产生额外的质量调整生命年。然而，需要进一步研究，考虑更详细的资源使用情况以及如病情加重等事件，以全面评估AA治疗的成本效益。
