BioMedEcon, LLC, Moss Beach, CA 94038, USA.
J Allergy Clin Immunol. 2013 Apr;131(4):1084-91. doi: 10.1016/j.jaci.2012.12.662. Epub 2013 Jan 30.
Research demonstrates significant health care cost savings conferred by allergen-specific immunotherapy (AIT) to US children with allergic rhinitis (AR).
We sought to examine whether AIT-related cost benefits conferred to US children with AR similarly extend to adults.
A retrospective (1997-2009) Florida Medicaid claims analysis compared mean 18-month health care costs of patients with newly diagnosed AR who received de novo AIT and were continuously enrolled for 18 months or more versus matched control subjects not receiving AIT. Analyses were conducted for the total sample and separately for adults (age≥18 years) and children (age<18 years).
Matched were 4,967 patients receiving AIT (1,319 adults and 3,648 children) and 19,278 control subjects (4,815 adults and 14,463 children). AIT-treated enrollees incurred 38% ($6,637 vs $10,644, P<.0001) lower mean 18-month total health care costs than matched control subjects, with significant savings observed within 3 months of AIT initiation. Compared with control subjects, significantly lower 18-month mean health care costs were demonstrated overall (38%; $6,637 for patients receiving AIT vs $10,644 for control subjects, P<.0001), and for both AIT-treated adults (30%; $10,457 AIT vs $14,854 controls, P<.0001) and children (42%; $5,253 AIT vs $9,118 controls, P<.0001). The magnitude of 18-month health care cost savings realized by AIT-treated adults and children did not significantly differ ($4,397 vs $3,965, P=.435).
Patients with newly diagnosed AR initiating AIT incurred significantly lower health care costs than matched control subjects beginning 3 months after AIT initiation and continuing throughout the 18-month follow-up period. The significant cost benefits achieved by children with AR diagnoses who initiated AIT were also observed for adults with AR diagnoses who initiated AIT.
研究表明，变应原特异性免疫疗法（AIT）可显著降低美国过敏性鼻炎（AR）患儿的医疗保健费用。
我们旨在研究 AIT 相关的成本效益是否同样适用于美国的成年 AR 患者。
回顾性（1997-2009 年）佛罗里达州医疗补助计划索赔分析比较了新诊断为 AR 并接受初始 AIT 且连续登记 18 个月或以上的患者与未接受 AIT 的匹配对照者在 18 个月内的平均医疗保健费用。分析针对总样本以及成人（年龄≥18 岁）和儿童（年龄<18 岁）分别进行。
匹配了 4967 名接受 AIT（1319 名成人和 3648 名儿童）的患者和 19278 名对照者（4815 名成人和 14463 名儿童）。接受 AIT 治疗的患者在 18 个月内的总医疗保健费用比匹配的对照组低 38%（6637 美元与 10644 美元，P<.0001），并且在 AIT 开始后 3 个月内就观察到了显著的节省。与对照组相比，总体上显示出 18 个月内的平均医疗保健费用显著降低（38%；6637 美元用于接受 AIT 的患者与 10644 美元用于对照组，P<.0001），以及接受 AIT 治疗的成人（30%；10457 美元用于 AIT 与 14854 美元用于对照组，P<.0001）和儿童（42%；5253 美元用于 AIT 与 9118 美元用于对照组，P<.0001）。接受 AIT 治疗的成人和儿童在 18 个月内实现的医疗保健成本节约幅度没有显著差异（4397 美元与 3965 美元，P=.435）。
新诊断为 AR 并开始 AIT 的患者比 AIT 开始后 3 个月开始并持续 18 个月随访的匹配对照组患者的医疗保健费用显著降低。接受 AIT 治疗的 AR 诊断的儿童和成人的显著成本效益也适用于接受 AIT 治疗的 AR 诊断的成人。
