Chapurin Nikita, Khan Sofia, Gutierrez Jorge, Soler Zachary M
Department of Otolaryngology - Head and Neck Surgery, Division of Rhinology and Endoscopic Skull Base Surgery, 2345Medical University of South Carolina, Charleston, South Carolina, USA.
Am J Rhinol Allergy. 2023 Mar;37(2):227-231. doi: 10.1177/19458924221147501.
Chronic rhinosinusitis (CRS) with nasal polyposis (CRSwNP) is a chronic inflammatory condition with significant patient morbidity and associated healthcare costs. While the economic burden of CRS overall has been previously described, the economic impact of CRSwNP has received less attention. Patients with CRSwNP have higher disease burden and healthcare resource utilization than those with CRS without nasal polyposis. Rapid evolution of medical management in recent years with the use of targeted biologics warrants further investigation into the economic burden of CRSwNP.
Provide an updated review of the literature on the economic impact of CRSwNP.
A literature review.
Research shows that patients with CRSwNP have higher direct costs and usage of ambulatory services compared to matched non-CRS controls. Patients undergoing functional endoscopic sinus surgery (FESS) incur roughly $13,000 in costs which is particularly relevant given the rate of disease recidivism and need for revision surgery associated with CRSwNP. Disease burden additionally leads to indirect costs through loss of wages and productivity due to work absenteeism and presenteeism, with estimates of up to roughly $10,000 lost in mean annual productivity cost in refractory CRSwNP. Several studies have shown FESS to be more cost-effective in intermediate and long-term management than medical therapy with biologics, despite similar long-term outcomes with respect to quality-of-life metrics.
CRSwNP is a chronic condition with high recurrence rates making it a challenge to manage over time. Current research suggests that FESS is more cost-effective than medical management, including use of newer biologics. Further investigation into both direct and indirect costs associated with medical management is warranted to perform accurate cost-effectiveness analyses and allow for the best allocation of limited healthcare resources.
伴鼻息肉的慢性鼻-鼻窦炎（CRSwNP）是一种慢性炎症性疾病，给患者带来了极大的痛苦，并产生了相关的医疗费用。虽然此前已有关于CRS总体经济负担的描述，但CRSwNP的经济影响却较少受到关注。与不伴有鼻息肉的CRS患者相比，CRSwNP患者的疾病负担更重，医疗资源利用率更高。近年来，随着靶向生物制剂的应用，药物治疗迅速发展，这使得有必要进一步研究CRSwNP的经济负担。
对有关CRSwNP经济影响的文献进行更新综述。
进行文献综述。
研究表明，与匹配的非CRS对照组相比，CRSwNP患者的直接成本更高，门诊服务使用率也更高。接受功能性鼻内镜鼻窦手术（FESS）的患者大约要花费13,000美元，鉴于CRSwNP的疾病复发率以及再次手术的需求，这一成本尤其值得关注。疾病负担还会因旷工和出勤但低效工作导致工资损失和生产力下降，从而产生间接成本，据估计，难治性CRSwNP的平均年度生产力成本损失高达约10,000美元。多项研究表明，尽管在生活质量指标方面长期结果相似，但在中长期治疗中，FESS比使用生物制剂的药物治疗更具成本效益。
CRSwNP是一种复发率高的慢性病，长期管理具有挑战性。目前的研究表明，FESS比包括使用新型生物制剂在内的药物治疗更具成本效益。有必要进一步研究与药物治疗相关的直接和间接成本，以进行准确的成本效益分析，并实现有限医疗资源的最佳分配。
