Lang Kathleen, Allen-Ramey Felicia, Huang Huan, Rock Marvin, Kaufman Elise, Dykewicz Mark S
Quintiles Valuie & Outcomes Advisory Services, Cambridge, Massachusetts, USA.
Allergy Asthma Proc. 2016 Sep;37(5):103-11. doi: 10.2500/aap.2016.37.3984.
Health care resource use (HRU) and costs among patients with seasonal allergic rhinitis (SAR) and perennial allergic rhinitis (PAR) have not been widely studied.
To develop an algorithm to classify patients with SAR and patients with PAR, and to evaluate treatment patterns, HRU, and costs among these patients.
Patients with allergic rhinitis (AR) were identified retrospectively by using electronic medical records and administrative claims data, with an index date as the earlier of the date of AR diagnosis or allergy medication use. Patients with AR were followed-up from 12 months before the index date through 12 months after the index date (follow-up) and were classified as SAR or PAR based on medication patterns during follow-up. AR-related HRU, allergy immunotherapy administration, and costs per patient per year during follow-up were compared between patients with SAR and those with PAR, with analyses stratified by asthma diagnosis before the index date and by physician specialty (primary care physician versus specialist).
Approximately 23% of patients with AR were classified as having PAR and 77% as having SAR. During follow-up, the patients with PAR had more allergy medication prescriptions versus the patients with SAR (8.0 versus 2.4 prescriptions), higher prescription medication costs ($1551 versus $313), higher allergy immunotherapy cost ($180 versus. $118), and higher total AR-related costs ($1944 versus $643); all with p < 0.001. Patients with asthma had higher costs than those without asthma. Patients seen by a specialist has higher costs than those treated by a primary care physician.
Patients with PAR experienced more AR-related prescription drug use and higher health care costs than patients with SAR, with prescription drug costs being the main cost driver. Treatments that reduce the need for ongoing prescription medication use have the potential to be cost saving.
季节性变应性鼻炎(SAR)和常年性变应性鼻炎(PAR)患者的医疗资源使用(HRU)及费用尚未得到广泛研究。
开发一种算法对SAR患者和PAR患者进行分类,并评估这些患者的治疗模式、HRU及费用。
通过电子病历和行政索赔数据回顾性识别变应性鼻炎(AR)患者,以索引日期作为AR诊断日期或过敏药物使用日期中较早者。AR患者从索引日期前12个月至索引日期后12个月进行随访(随访期),并根据随访期间的用药模式分为SAR或PAR。比较SAR患者和PAR患者在随访期间与AR相关的HRU、过敏免疫治疗的实施情况以及每年每位患者的费用,分析按索引日期前的哮喘诊断和医生专业(初级保健医生与专科医生)进行分层。
约23%的AR患者被分类为患有PAR,77%为患有SAR。在随访期间,PAR患者比SAR患者有更多的过敏药物处方(8.0张对2.4张)、更高的处方药费用(1551美元对313美元)、更高的过敏免疫治疗费用(180美元对118美元)以及更高的与AR相关的总费用(1944美元对643美元);所有p均<0.001。有哮喘的患者费用高于无哮喘的患者。由专科医生诊治的患者费用高于由初级保健医生治疗的患者。
与SAR患者相比,PAR患者经历了更多与AR相关的处方药使用和更高的医疗费用,处方药费用是主要的费用驱动因素。减少持续使用处方药需求的治疗方法有可能节省费用。