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Titolo:
Cost-effectiveness of inhaled corticosteroids in adults with mild-to-moderate asthma: Results from the Asthma Policy Model
Autore:
Paltiel, AD; Fuhlbrigge, AL; Kitch, BT; Liljas, B; Weiss, ST; Neumann, PJ; Kuntz, KM;
Indirizzi:
Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, New Haven, CT 06520 USA Yale Univ New Haven CT USA 06520 iol & Publ Hlth, New Haven, CT 06520 USA Brigham & Womens Hosp, Dept Med, Channing Lab, Boston, MA USA Brigham & Womens Hosp Boston MA USA pt Med, Channing Lab, Boston, MA USA Harvard Univ, Sch Med, Boston, MA USA Harvard Univ Boston MA USAHarvard Univ, Sch Med, Boston, MA USA AstraZeneca, Lund, Sweden AstraZeneca Lund SwedenAstraZeneca, Lund, Sweden Harvard Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 olicy & Management, Boston, MA 02115 USA
Titolo Testata:
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
fascicolo: 1, volume: 108, anno: 2001,
pagine: 39 - 46
SICI:
0091-6749(200107)108:1<39:COICIA>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
HOSPITAL EMERGENCY DEPARTMENTS; FLUTICASONE PROPIONATE POWDER; METERED-DOSE INHALER; BECLOMETHASONE DIPROPIONATE; PERSISTENT ASTHMA; NEDOCROMIL SODIUM; UNITED-STATES; CHILDREN; SALMETEROL; RISK;
Keywords:
asthma; inhaled corticosteroids; cost-effectiveness analysis; decision analysis; Markov models;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
79
Recensione:
Indirizzi per estratti:
Indirizzo: Paltiel, AD Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, 60 Coll St, New Haven, CT 06520 USA Yale Univ 60 Coll St New Haven CT USA 06520 aven, CT 06520 USA
Citazione:
A.D. Paltiel et al., "Cost-effectiveness of inhaled corticosteroids in adults with mild-to-moderate asthma: Results from the Asthma Policy Model", J ALLERG CL, 108(1), 2001, pp. 39-46

Abstract

Background: Inhaled corticosteroids remain underused among United States-based clinicians in treating mild-to-moderate adult asthma. Objective: The purpose of this investigation was to estimate the clinical impact, health-related quality of life, cost, and cost-effectiveness of inhaled corticosteroid therapy in a population of patients aged 18 years and over with FEV1 = 60% to 100% of predicted normal. Methods: We performed a cost-effectiveness analysis of quick relievers (eg, short-acting beta -agonists) on an as-needed basis plus inhaled corticosteroid therapy versus quick relievers alone. A mathematical simulation modelwas developed to forecast symptoms, acute exacerbations, quality-adjusted life-years (QALYs), health care costs, and cost-effectiveness, measured in both dollars per QALY gained and dollars per symptom-free day gained. All evaluation outcomes were discounted at an annual rate of 3% and measured over a 10-year planning horizon. Data on the natural history of disease, drug efficacy, patient preferences, and economic costs were obtained from a variety of observational cohorts, randomized trials, and patient surveys. Results: Over a 10-year period, use of inhaled corticosteroids increases total health costs from roughly $5,200 to $8,400 and improves QALYs from 6.8to 7.0, implying an incremental cost of $13,500 per QALY gained. Costs persymptom-free day gained are $7.50. Both per-person acute exacerbations andhospitalizations are reduced by 33%. The cost-effectiveness findings are sensitive to the assumed efficacy and side-effects of inhaled corticosteroidtherapy. Conclusions: Inhaled corticosteroids appear to deliver good comparative value in adults with mild-to-moderate asthma. Although more research is needed to understand their impact on preferences regarding side effects and compliance, these findings might be useful for priority-setting in limited resource situations.

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Documento generato il 23/01/21 alle ore 03:43:52