PDF(Pubmed)
Abstract：
Objectives: Perennial allergic rhinitis (PAR) is common in Japan. Second-generation antihistamines (SGAs) are commonly used for its treatment; however, it remains unclear which SGA is the most cost-effective. Additionally, the pharmacoeconomics of Japanese Kampo shoseiryuto (which was traditionally prescribed to treat PAR in Japan) remains poorly understood. In this study, we aimed to investigate the effectiveness of various SGAs and shoseiryuto for the treatment of PAR in Japanese outpatients, from the healthcare payer\'s perspective. Methods: The most cost- and clinically effective SGAs were determined from a list of 6 SGAs (bepotastine, 10 mg; cetirizine, 10 mg; ebastine, 10 mg; epinastine, 20 mg; loratadine, 10 mg; and olopatadine, 5 mg) together with shoseiryuto, using the overall improvement rate through a model-based analysis. The time horizon was 28 days. Costs were determined based on the Medical Fee Index in 2020. Deterministic and probabilistic sensitivity analyses were conducted to address the uncertainty of the base-case results. Results: Overall, bepotastine (10 mg) and ebastine (10 mg) were cost-effective. Shoseiryuto was less cost-effective than ebastine (10 mg) (dominated). Ebastine (10 mg) was the most cost-effective option based on deterministic and probabilistic sensitivity analyses. Conclusions: Ebastine (10 mg) was the most cost-effective treatment strategy for PAR among the agents evaluated in this study. This insight could aid in establishing an appropriate formulary for treating PAR in hospitals and communities.
摘要：
目的：常年性变应性鼻炎（PAR）在日本很常见。第二代抗组胺药（SGAs）通常用于治疗；然而，尚不清楚哪种SGA最具成本效益.此外,日本Kamposhoseiryuto(传统上在日本用于治疗PAR)的药物经济学仍然知之甚少.在这项研究中,我们旨在调查各种SGA和shoseiryuto在日本门诊患者中治疗PAR的有效性，从医疗保健支付者的角度来看。方法：从6个SGA（bepotastine，10毫克；西替利嗪，10毫克；依巴斯汀，10毫克；epinastine，20毫克；氯雷他定，10毫克；和奥洛他定，5毫克)与shoseiryuto一起，通过基于模型的分析使用总体改进率。时间范围为28天。费用是根据2020年的医疗费用指数确定的。进行了确定性和概率敏感性分析，以解决基本情况结果的不确定性。结果：总体而言，bepotastine（10mg）和ebastine（10mg）具有成本效益。Shoseiryuto的成本效益低于依巴斯汀（10mg）（占主导地位）。基于确定性和概率敏感性分析，依巴斯汀（10mg）是最具成本效益的选择。结论：在本研究评估的药物中，Ebastine（10mg）是最具成本效益的PAR治疗策略。这种见解可以帮助建立适当的处方来治疗医院和社区的PAR。
