From the Division of Allergy and Immunology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Health Economics and Outcomes Research, Optum Life Sciences, Eden Prairie, Minnesota.
Allergy Asthma Proc. 2022 Sep 1;43(5):435-445. doi: 10.2500/aap.2022.43.220048.
Limited data exist on the clinical and economic burden of chronic rhinosinusitis with nasal polyposis (CRSwNP). To describe patient characteristics, health-care resource utilization (HCRU), and health-care costs among patients with CRSwNP with and without comorbid asthma (primary analysis) and with surgical management of nasal polyps (secondary analysis). This was a retrospective study of patients diagnosed with CRSwNP conducted using administrative claims data from January 1, 2013, through March 31, 2019. Study outcomes were assessed over a 2-year follow-up. Results were stratified by baseline asthma status (primary analysis) and presented separately for patients with surgically managed CRSwNP (secondary analysis). The primary analysis included 10,999 patients with CRSwNP (2649 with asthma, 8350 without asthma). Patients with versus without asthma had higher medication use, HCRU, and all-cause medical costs (mean ± standard deviation $34,667 ± $42,234 versus $27,122 ± $45,573; p < 0.001) across the full follow-up period. CRSwNP-related medical costs were significantly higher for patients with versus without asthma in year 2 of follow-up. In the surgical management analysis (n = 4943), most categories of medication use and CRSwNP-related HCRU declined from baseline levels during follow-up, and CRSwNP-related pharmacy costs in year 2 were less than half of baseline levels. Patients diagnosed with CRSwNP and asthma had a greater burden of illness than those without asthma. Higher CRSwNP-related medical costs in year 2 of follow-up for patients with asthma may indicate worsening symptoms over time. Among patients with surgically managed CRSwNP, HCRU and costs increased in year 1 of follow-up but decreased below baseline levels in year 2, potentially reflecting improved symptom severity.
慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）的临床和经济负担数据有限。本研究旨在描述伴有和不伴有哮喘（主要分析）以及接受鼻息肉手术治疗（次要分析）的 CRSwNP 患者的患者特征、医疗资源利用（HCRU）和医疗保健费用。这是一项回顾性研究，使用了 2013 年 1 月 1 日至 2019 年 3 月 31 日期间的行政索赔数据，纳入了诊断为 CRSwNP 的患者。在为期 2 年的随访期间评估了研究结果。根据基线哮喘状态进行分层（主要分析），并分别为接受鼻息肉手术治疗的患者呈现结果（次要分析）。主要分析纳入了 10999 例 CRSwNP 患者（2649 例伴有哮喘，8350 例不伴有哮喘）。与不伴有哮喘的患者相比，伴有哮喘的患者药物使用、HCRU 和全因医疗费用更高（平均值±标准差：$34667 ± $42234 对 $27122 ± $45573；p<0.001），且在整个随访期间均如此。在随访的第 2 年，伴有哮喘的患者的 CRSwNP 相关医疗费用显著高于不伴有哮喘的患者。在手术治疗分析中（n=4943），大多数药物使用和 CRSwNP 相关 HCRU 类别在随访期间从基线水平下降，且第 2 年的 CRSwNP 相关药房费用不到基线水平的一半。诊断为 CRSwNP 伴哮喘的患者比不伴哮喘的患者疾病负担更重。伴有哮喘的患者在随访的第 2 年的 CRSwNP 相关医疗费用更高，这可能表明症状随时间恶化。在接受手术治疗的 CRSwNP 患者中，在随访的第 1 年 HCRU 和费用增加，但在第 2 年下降到低于基线水平，这可能反映了症状严重程度的改善。
