García Robaina José Carlos, Polanco Sánchez Carlos, Estella Pérez Elvira
Allergy Department, University Hospital Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain.
Health Economics & Outcomes Research, Corporate Affairs, Merck S.L., Madrid, Spain.
Clinicoecon Outcomes Res. 2016 Jun 14;8:235-41. doi: 10.2147/CEOR.S107123. eCollection 2016.
To quantify the cost difference between conventional symptomatic treatment of mite allergy and specific subcutaneous immunotherapy (SCIT).
Observational, retrospective, and multicenter study was carried out in Spain in 2013. The medical records of 419 patients diagnosed with rhinitis and/or bronchial asthma for mite allergy were retrieved. Mean age was 24.9 years (standard deviation 14.4). The use of symptomatic medication (rescue and daily), diagnostic tests, unscheduled medical care, and sick leave days associated with SCIT treatment versus no-SCIT treatment was compared. Also measured was the SCIT treatment to no-SCIT treatment costs ratio: used resources (symptomatic medication, unscheduled medical care, diagnostic tests, and 3 years SCIT treatment and sick leave days) were quantified in euros. Efficacy (decreased resource usage) of first-year treatment was assumed during the remaining 2 years and also during the 3-year follow-up period.
After a single year of SCIT, all quantified resources diminished significantly (P<0.05) from baseline. Estimated reduction in cost items included hospital resources (100% in hospitalizations, 82% in visits to the allergist, and 79% in emergency room visits), therapies (56% in rescue medication and 63% in daily medication), diagnostic tests (77%), and sick leave days (94%). Ratio of comparative calculation described as SCIT treatment versus non-SCIT treatment (or conventional symptomatic treatment) is 0.8.
Direct costs are reduced by 64% and indirect costs by 94%. SCIT of hypoallergenic preparation of dust mite (Acaroid(®)) allows cost savings versus conventional treatment. Estimated savings for the public National Health System are 5.7 times the cost of immunotherapy.
量化尘螨过敏的传统对症治疗与特异性皮下免疫疗法（SCIT）之间的成本差异。
2013年在西班牙开展了一项观察性、回顾性多中心研究。检索了419例诊断为尘螨过敏所致鼻炎和/或支气管哮喘患者的病历。平均年龄为24.9岁（标准差14.4）。比较了SCIT治疗组与非SCIT治疗组在使用对症药物（急救和日常用药）、诊断检查、非计划医疗护理以及病假天数方面的差异。还测量了SCIT治疗与非SCIT治疗的成本比：将所使用的资源（对症药物、非计划医疗护理、诊断检查以及3年的SCIT治疗和病假天数）以欧元为单位进行量化。在剩余2年以及3年随访期内，假定第一年治疗的疗效（资源使用减少）持续存在。
经过一年的SCIT治疗后，所有量化资源均较基线显著减少（P<0.05）。成本项目的估计减少包括医院资源（住院减少100%，过敏专科医生就诊减少82%，急诊就诊减少79%）、治疗（急救药物减少56%，日常用药减少63%）、诊断检查（减少77%）以及病假天数（减少94%）。SCIT治疗与非SCIT治疗（或传统对症治疗）的比较计算比值为0.8。
直接成本降低了64%，间接成本降低了94%。与传统治疗相比，尘螨（Acaroid(®)）低变应原制剂的SCIT可节省成本。估计为国家公共卫生系统节省的费用是免疫疗法成本的5.7倍。
