Azzano Pauline, Dufresne Élise, Poder Thomas, Bégin Philippe
Department of Pediatrics, CHU Sainte-Justine, Montreal, QC, Canada.
Department of Management, Evaluation and Health Policy, School of Public Health, University of Montreal, Montreal, QC, Canada.
Allergy. 2021 Jan;76(1):191-209. doi: 10.1111/all.14494. Epub 2020 Sep 6.
The advent of biologic therapies has transformed care for severe atopic disorders but their high cost poses new challenges with regard to long-term sustainability and fair allocation of resources. This article covers the basic concepts of cost-utility analyses and reviews the available literature on cost utility of biologic drugs in atopic disorders. When used within their limits as part of a multi-dimensional assessment, economic analyses can be extremely useful to guide decision-making and prioritization of care. Despite the good quality of most cost-utility analyses conducted for the use of biologics in asthma and other atopic diseases, their conclusions regarding cost-effectiveness are extremely variable. This is mainly due to the use of inconsistent estimates of health utility benefit with therapy. Development of reliable and validated instruments to measure disutility in atopic disorders and measure of indirect costs in atopic disease are identified as a priority for future research.
生物疗法的出现改变了重度特应性疾病的治疗方式，但它们的高成本给长期可持续性和资源公平分配带来了新挑战。本文涵盖了成本效用分析的基本概念，并回顾了关于生物药物在特应性疾病中成本效用的现有文献。当在其局限性内作为多维评估的一部分使用时，经济分析对于指导护理决策和优先排序非常有用。尽管大多数针对生物制剂在哮喘和其他特应性疾病中的使用进行的成本效用分析质量良好，但它们关于成本效益的结论却极具差异。这主要是由于对治疗的健康效用效益估计不一致。开发可靠且经过验证的工具来衡量特应性疾病中的负效用以及测量特应性疾病中的间接成本被确定为未来研究的重点。
