变应性鼻炎合并哮喘免疫治疗卫生经济学分析

Health economics analysis of specific immunotherapy in allergic rhinitis accompanied with asthma

目的:评价以尘螨过敏为主的变应性鼻炎合并哮喘患者行标准化特异性免疫治疗的成本-效果。方法:对临床上40例变应性鼻炎合并哮喘患者,分为免疫治疗组及对照组(单纯药物治疗),进行成本-效果分析,具体指标包括鼻部及哮喘症状得分,生活质量,鼻炎及哮喘主观改善程度的成本-效果及增量成本-效果比,并应用敏感度分析来验证结果的稳定性。结果:免疫治疗组1年治疗成本(6 578元)高于对照组(1 733.3元),但各项指标的成本-效果比及增量成本效果比均优于对照组,进行价格上下波动10%的敏感度分析,免疫治疗组亦优于对照组。结论:尘螨过敏为主的变应性鼻炎合并哮喘进行特异性免疫治疗成本-效果优于药物治疗组。

Objective： To investigate the cost-effectiveness of standardized specific immunotherapy（SIT） for allergic rhinitis patients accompanied with asthma（ARAS） in China. Method：Forty ARAS patients sensitized with house dust mite（HDM） were administered with SIT（SIT group） or merely medicine treatment （control group）. Alutard dermatophagoides pteronyssinus vaccine from ALK company was used for immunotherapy. The usage of symptom control medicine was according to the ARIA and GINA guideline. Cost-effectiveness ratio（CER） and In- cremental cost-effectiveness ratio （ICER） analysis was conducted. The effectiveness was measured in terms of symptom scores, quality of life, objective improvement of rhinitis and asthma. Sensitive analysis was conducted to verify the stability of the results. Result：The cost of SIT group for I year（6578 yuan） was higher than that of con- trol group（1 733.3 yuan）, while the cost-effectiveness ratio and incremental cost-effectiveness ratio of SIT group were significant better than that of control group in all items. CER was 1 686.7 yuan in SIT group compared with 3466.6 yuan in control group for nasal symptom scores, 4698.6 yuan in SIT group compared with 5777.8 yuan in control group for asthma symptom scores, 3 462. 1 yuan in SIT group compared with 8 666. 7 yuan in control group. The sensitive analysis of the price 10 percent higher or lower showed the same results. Conclusion.. The cost-effectiveness of specific immunotherapy（SIT） for mite sensitized ARAS patients was better than that of mere- ly medicine treatment.