单次维护和缓解疗法的成本与喘传统治疗的成本
Tri Pham1, Abigail R Barker2, Sarah A Eisenstein2
1Department of Medicine, Washington University in St Louis School of Medicine, St Louis, Missouri.
JAMA network open
|February 2, 2026
概括
与传统方法相比,用于喘管理的单一维护和缓解疗法 (SMART) 是具有成本效益的,提供适度的节省和改善健康结果. 扩大SMART的保险覆盖范围可以降低医疗保健成本并减少喘相关疾病.
科学领域:
- 卫生经济学 卫生经济学
- 药物经济学 药物经济学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 单次维护和缓解疗法 (SMART) 尽管有指导方针建议,但在美国仍未得到充分利用.
- 适用于SMART兼容的吸入器的有限保险覆盖面是采用的重要障碍.
研究的目的:
- 从美国医疗保健支付人的角度来看,比较SMART与传统治疗的年度喘管理成本.
- 评估SMART在管理中度至重度喘方面的成本效益.
主要方法:
- 使用蒙特卡洛模拟的概率决策树模型.
- 从6个随机临床试验和当前的喘指南系统审查了数据.
- 在1年的时间里,分析了与喘相关的年度成本和经质量调整的寿命年 (QALYs).
主要成果:
- 据估计,每年每位患者的SMART治疗费用为2181美元,而传统治疗费用为2235美元.
- SMART与QALYs中适度的增长有关 (每个患者的0.0006).
- 在57%的模拟中 (没有QALY),SMART的成本更低,在67%的模拟中 (具有QALY) 具有更高的成本效益.
结论:
- 与传统的喘治疗相比,SMART证明了成本效益和改善的健康结果.
- 扩大SMART的保险覆盖范围可能会减少与喘相关的发病率和医疗保健支出.
- 在中度至重度喘管理中,SMART 是一种有价值的治疗策略.
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