哮喘联盟

   摘要
   目的：明确奥马珠单抗与常规临床诊疗相比，治疗及控制重症持续性哮喘的成本效益。
   方法：研究招募了马拉加维多利亚大学附属医院呼吸科的47名患者，分别在奥马珠单抗治疗前10个月及治疗后10个月进行成本效益分析。成本效益通过以下数据进行评估：因哮喘发作而进入急诊的次数，质量校正寿命。然后以国家卫生系统为基准，分析奥马珠单抗及急诊就医的费用。以费用/获得的质量校正寿命和费用/避免的急诊就诊次数两个比值来表达结果。
   结果：与奥马珠单抗治疗前10个月相比，治疗后10个月患者因哮喘发作而急诊就医的次数显著下降[7.94 (6.52-9.37) 和0.19 (0.03-0.35)，p<0.001]。同时，健康状况显著上升 [0.5967 (0.5722-0.6212) vs 0.7566 (0.7232-0.7900)]，意味着获得了0.1333 (0.1053-0.1612) 质量校正寿命。治疗前10个月每名病人的平均花费为€ 1,850.78 (1,519.46-2,182.10)，治疗后10个月为€ 5,431.87 (4,930.72-5,933.02)。增量成本效益比分别为€ 462.08/避免的发作次数 (347.65-606.22) 和€ 26,864.89/获得的质量校正寿命(21,632.07-33,859.49)。
   结论：试验结果证实对未能控制病情的重症持续哮喘患者进行奥马珠单抗治疗10个月，可显著降低因哮喘发作而急诊就医的次数，并提高健康相关的生活质量。增量成本效益支持奥马珠单抗的使用并符合卫生系统标准。
 

（苏楠 审校）
J Asthma. 2014 Jul 4:1-26. [Epub ahead of print]

 

Cost-effectiveness of omalizumab in severe persistent asthma in spain: a real-life perspective.
 

Levy AN1, García AR, García-Agua NS, Hidalgo MV.
 

ABSTRACT
OBJECTIVES: To determine the cost-effectiveness of omalizumab compared with routine clinical practice in the treatment and control of severe persistent asthma.
METHODS: Cost-effectiveness analysis using pre- and post-treatment with omalizumab after 10 months of 47 patients diagnosed with uncontrolled severe persistent asthma attended by the Pneumology Service, Hospital Universitario Virgen de la Victoria, Malaga. Effectiveness was assessed by the number of emergency room (ER) visits for exacerbations and quality-adjusted life years (QALY) gained. The costs of treatment with omalizumab and ER visits were analyzed using the National Health System perspective. Results are expressed in cost per QALY gained and cost per ER visit avoided (costs € 2012).
RESULTS: Exacerbations with ER visits decreased significantly (p<0.001) after 10 months of omalizumab treatment compared with the previous 10 months [7.94 (6.52-9.37) vs 0.19 (0.03-0.35)]. Health utilities increased significantly (p<0.001) during the same period [0.5967 (0.5722-0.6212) vs 0.7566 (0.7232-0.7900)], representing 0.1333 (0.1053-0.1612) QALYs gained (p<0.001).The mean cost per patient was € 1,850.78 (1,519.46-2,182.10) in the 10 months before treatment and € 5,431.87 (4,930.72-5,933.02) after 10 months of omalizumab treatment. The incremental cost-effectiveness ratios were € 462.08/exacerbation avoided (347.65-606.22) and € 26,864.89/QALY gained (21,632.07-33,859.49).
CONCLUSIONS: Our results confirm that adding omalizumab to the treatment of patients with uncontrolled severe persistent asthma reduces the number of exacerbations with ER visits and increases health-related quality of life after 10 months of treatment, and produces incremental cost-effectiveness ratios favorable to omalizumab and acceptable from the health system perspective.
 

J Asthma. 2014 Jul 4:1-26. [Epub ahead of print]