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支气管热成形术在商业保险的控制不佳的重度持续性哮喘患者中的成本效益。

Cost-effectiveness of bronchial thermoplasty in commercially-insured patients with poorly controlled, severe, persistent asthma.

作者信息

Cangelosi Michael J, Ortendahl Jesse D, Meckley Lisa M, Bentley Tanya G K, Anene Ayanna M, Shriner Kelly M, Fox John

机构信息

Boston Scientific Corporation, Marlborough, MA, USA.

出版信息

Expert Rev Pharmacoecon Outcomes Res. 2015 Apr;15(2):357-64. doi: 10.1586/14737167.2015.978292. Epub 2014 Nov 1.

Abstract

OBJECTIVES

We examined the cost-effectiveness of treating poorly controlled, severe, persistent asthma patients with bronchial thermoplasty (BT), a novel technology that uses thermal energy to reduce airway smooth muscle mass, with 5-year outcome data demonstrating a durable reduction in asthma exacerbations.

STUDY DESIGN

We conducted a model-based cost-effectiveness analysis assessing 5-year healthcare utilization, patient quality of life and adverse events.

METHODS

We utilized Markov modeling to estimate the costs and quality-of-life impact of BT compared with high-dose combination therapy among poorly controlled, severe, persistent asthma patients: those requiring high-dose combination therapy and having experienced an asthma exacerbation-related ER visit in the past year.

RESULTS

The cost-effectiveness of BT was US$5495 per quality-adjusted life year; and approximately 22% of sensitivity analysis iterations estimated BT to reduce costs and increase quality of life.

CONCLUSIONS

BT is a cost-effective treatment option for patients with poorly controlled, severe, persistent asthma.

摘要

目的

我们研究了支气管热成形术(BT)治疗控制不佳的重度持续性哮喘患者的成本效益。BT是一种利用热能减少气道平滑肌质量的新技术,5年的结果数据表明哮喘发作可持久减少。

研究设计

我们进行了一项基于模型的成本效益分析,评估5年的医疗保健利用率、患者生活质量和不良事件。

方法

我们利用马尔可夫模型估计了在控制不佳的重度持续性哮喘患者中,BT与高剂量联合治疗相比的成本和生活质量影响,这些患者需要高剂量联合治疗且在过去一年中因哮喘发作相关的急诊就诊。

结果

BT的成本效益为每质量调整生命年5495美元;约22%的敏感性分析迭代估计BT可降低成本并提高生活质量。

结论

对于控制不佳的重度持续性哮喘患者,BT是一种具有成本效益的治疗选择。

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