对患有喘症状无法控制的儿童治疗的成本效益分析,尽管吸入皮质类固醇
Giovanna Culeddu1, Sofia Cividini2, Ian Sinha3
1Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, Wales, UK.
Pediatric pulmonology
|December 15, 2025
概括
在英国,对未经控制的儿童喘的治疗升级是不具有成本效益的,除非药物价格下降或治疗针对高风险患者. 需要进一步研究吸入性皮质类固醇 (ICS) 和长效β2-激动剂 (LABA) 的成本效益.
科学领域:
- 卫生经济学 卫生经济学
- 儿科肺病学 儿科肺病学
- 药物经济学 药物经济学
背景情况:
- 尽管吸入性皮质类固醇 (ICS) 治疗,但儿童和青少年的非控制性喘存在重大管理挑战.
- 在英国国家卫生服务 (NHS) 等医疗保健系统中,各种治疗升级策略的成本效益仍然不确定.
研究的目的:
- 评估不同喘治疗方案的成本效益,用于患有未控制喘的儿科患者.
- 为了比较低剂量ICS,中剂量ICS,高剂量ICS,ICS/长效β2上腺素受体激动剂 (LABA) 和白血素受体对抗剂 (LTRA) 疗法.
主要方法:
- 从NHS的角度来看,使用马尔科夫状态过渡模型来模拟1年时间的成本和健康结果.
- 关于医疗保健资源使用和公用事业的数据来源于文献评论.
- 过渡概率通过系统审查和网络元分析来确定.
主要成果:
- 与低剂量ICS相比,中剂量ICS和ICS/LABA的增量成本效益比 (ICER) 分别为255,555英和304,956英,每增加的质量调整寿命年 (QALY).
- 高剂量的ICS,LTRA单疗法和LTRA/ICS组合疗法被更便宜,更有效的替代品所主导.
- 中剂量ICS的ICER显著改善至14,797英/QALY,并增加了恶化的风险概率,ICS/LABA变得具有成本效益,价格降低了60%以上.
结论:
- 在英国儿童中,将喘治疗扩大到低剂量ICS之外,只有在替代药物价格下降时,才可能具有成本效益.
- 针对患有喘恶化风险较高的患者进行升级治疗可以提高成本效益.
- 这些发现凸显了在治疗儿科喘时需要仔细考虑治疗成本和患者风险概况的必要性.
相关概念视频
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
1.5K
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
1.5K
01:30Asthma-IV: Diagnostic and Management
3.0K
The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
3.0K
01:26COPD: Management Using Bronchodilators and Corticosteroids
700
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
700
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
1.7K
Asthma is a chronic respiratory condition for which new therapeutic avenues, including anti-inflammatory drugs like mast cell stabilizers and anti-IgE treatments, continue to be developed.
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
1.7K
01:24Asthma-III: Symptoms and Complications
3.2K
Asthma, a common chronic respiratory condition, is classified considering the frequency and severity of symptoms alongside lung function impairment. Understanding this classification is essential for appropriate treatment and management. Here's a detailed look at the classification of asthma and its clinical features and complications:
Classification of Asthma
Classification of Asthma
3.2K
01:20Asthma: Pathogenesis and Management
1.2K
Asthma is a chronic pulmonary condition involving inflammation of the airways, hyper-reactivity, and reversible obstruction of the airways. This condition can significantly impact a person's quality of life, making breathing difficult and leading to distressing symptoms.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
1.2K