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糠酸莫米松与丙酸倍氯米松治疗哥伦比亚儿童过敏性鼻炎的成本效益分析

Cost-effectiveness analysis of mometasone furoate versus beclomethasone dipropionate for the treatment of pediatric allergic rhinitis in Colombia.

作者信息

Rodríguez-Martínez Carlos E, Sossa-Briceño Monica P, Vladimir Lemos Elkin

机构信息

Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Carrera 45 No. 26-85, Bogota, Colombia,

出版信息

Adv Ther. 2015 Mar;32(3):254-69. doi: 10.1007/s12325-015-0192-6. Epub 2015 Mar 10.

Abstract

INTRODUCTION

Allergic rhinitis (AR) is one of the most common chronic respiratory diseases observed in the pediatric population, producing a significant morbidity, and an economic burden due to direct medical costs and indirect costs. Despite the high prevalence of AR in children and the importance of the use of topical intranasal corticosteroids for its treatment, comparative analyses of alternative treatments in pediatric patients, in terms of both cost and effectiveness are lacking.

METHODS

A decision-analysis model was developed to estimate the cost-effectiveness of mometasone furoate nasal spray (MFNS) compared to beclomethasone dipropionate nasal spray (BDNS) for treating pediatric patients with AR over a 12-month period. Effectiveness parameters were obtained from a published study in which authors performed a systematic review of the literature. Cost data were obtained from a hospital's bills and from the national manual of drug prices. The study assumed the perspective of the national healthcare in Colombia. The outcomes were three effectiveness measures summarized in a therapeutic index (TIX).

RESULTS

For the base-case analysis, the model showed that compared to BDNS, therapy with MFNS was associated with lower costs (US$229.78 vs. 289.74 average cost per patient over 12 months) and a greater improvement in TIX score (0.9724 vs. 0.8712 score points on average per patient over 12 months), thus leading to dominance.

CONCLUSION

The present analysis shows that in Colombia, compared with BDNS, therapy with MFNS for treating pediatric patients with AR is a dominant strategy because it showed a greater improvement in a TIX reflecting both efficacy and safety, at lower total treatment costs.

摘要

引言

变应性鼻炎(AR)是儿科人群中最常见的慢性呼吸道疾病之一,因其直接医疗成本和间接成本而导致显著的发病率和经济负担。尽管儿童AR的患病率很高,且局部鼻用糖皮质激素在其治疗中具有重要作用,但缺乏关于儿科患者替代治疗在成本和效果方面的比较分析。

方法

开发了一个决策分析模型,以估计糠酸莫米松鼻喷雾剂(MFNS)与丙酸倍氯米松鼻喷雾剂(BDNS)相比,在12个月内治疗儿科AR患者的成本效益。有效性参数来自一项已发表的研究,该研究的作者对文献进行了系统综述。成本数据来自医院账单和国家药品价格手册。该研究采用了哥伦比亚国家医疗保健的视角。结果是在一个治疗指数(TIX)中总结的三种有效性测量指标。

结果

对于基础病例分析,该模型显示,与BDNS相比,MFNS治疗的成本更低(12个月内每位患者的平均成本为229.78美元对289.74美元),TIX评分改善更大(12个月内每位患者平均得分0.9724对0.8712分),从而导致优势。

结论

本分析表明,在哥伦比亚,与BDNS相比,MFNS治疗儿科AR患者是一种优势策略,因为它在反映疗效和安全性的TIX方面有更大改善,且总治疗成本更低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b7b/4376956/60f366312cce/12325_2015_192_Fig1_HTML.jpg

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