Asthma Cost-Effectiveness Analyses: Are We Using the Recommended Outcomes in Estimating Value?

被引:11
作者
Kim, Chong H. [1 ]
Dilokthornsakul, Piyameth [1 ,2 ]
Campbell, Jonathan D. [1 ]
van Boven, Job F. M. [1 ,3 ]
机构
[1] Univ Colorado, Ctr Pharmaceut Outcomes Res, Skaggs Sch Pharm & Pharmaceut Sci, Denver, CO 80202 USA
[2] Naresuan Univ, Fac Pharmaceut Sci, Dept Pharm Practice, Ctr Pharmaceut Outcomes Res, Phitsanulok, Thailand
[3] Univ Groningen, Univ Med Ctr Groningen, Groningen Res Inst Asthma & COPD, Dept Gen Practice, Antonius Deusinglaan 1,Rm 3217-423, NL-9713 AV Groningen, Netherlands
关键词
Asthma; Cost; Effectiveness; Cost-effectiveness; Cost-benefit; Review; PERSISTENT ALLERGIC-ASTHMA; WILLINGNESS-TO-PAY; ADD-ON OMALIZUMAB; ECONOMIC-EVALUATION; HEALTH ECONOMICS; INHALED CORTICOSTEROIDS; EMERGENCY-DEPARTMENT; UNCONTROLLED ASTHMA; UNITED-STATES; POLICY MODEL;
D O I
10.1016/j.jaip.2017.07.028
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
BACKGROUND: Asthma medication cost-effectiveness analyses (CEAs) lack the qualitative assessment regarding whether they capture the National Institutes for Health (NIH) 2012 recommended outcomes necessary to allow robust cross-study comparisons. OBJECTIVE: We aimed to assess the current asthma outcomes used in CEAs and recommend a direction for improvement. METHODS: We performed a systematic search using electronic databases including PubMed, EMBASE, Tufts CEA registry, Cochrane, and NHSEED from January 2010 through December 2015. Key words included (1) cost-effectiveness, cost-utility, economic evaluation, health economics, or cost-benefit AND (2) asthma. All CEA studies evaluating 1 or more asthma medication were included. Authors assessed each CEA study with respect to asthma-specific NIH outcome recommendations including core (hospitalizations, emergency department visits, outpatient visits, medication, interventions costs), supplemental (visit categories and work/school absence), and emerging (academic/job-related) asthma outcomes. Besides outcomes of each CEA, issues that could prevent robust cross-study comparison were identified and thematically summarized. RESULTS: A total of 12 pre-NIH and 14 post-NIH recommendation CEAs were included. Eleven (91.7%) and 14 (100%) of the pre-/post-NIH studies included at least 1 core outcome, respectively. Of the 26 total studies, 7 (26.9%) included asthma-specific outpatient visit categories, 6 (23.1%) included asthma school or work absences, 5 (19.2%) included respiratory health care use, and none of the studies included emerging outcomes. Other issues that hamper cross-study comparison include lack of standardized cost data, time frames, quality-of-life measures, and incorporation of adherence. CONCLUSIONS: Although the use of NIH-recommended asthma core outcomes has improved, there is still room for improvement in using supplemental and emerging outcomes. To allow robust cross-study comparisons, future work should focus on further standardizing of data sources and methods. (C) 2017 American Academy of Allergy, Asthma & Immunology
引用
收藏
页码:619 / 632
页数:14
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