伴有鼻息肉的慢性鼻鼻窦炎(CRSwNP)代表主要由2型炎症的存在引起的病症,并且以鼻窦和鼻旁窦内存在息肉为特征。护理标准包括鼻内类固醇,全身性类固醇的额外爆发,如果需要,和手术。然而,复发是常见的,尤其是患有2型炎症性疾病的患者。最近,生物药物,解决疾病的根本原因,已经在意大利获得批准(dupilumab,奥马珠单抗,和美泊利单抗)。进行了一项卫生技术评估,以定义多维影响,假设意大利NHS的观点和12个月的时间范围。EUnetHTA核心模型已部署,使用以下方法来分析领域:(i)文献证据;(ii)对17名医疗保健专业人员进行半结构化问卷管理;(iii)定义系统经济可持续性的健康经济学工具。来自NMA和ITC的证据显示,与替代生物制剂相比,dupilumab具有更有利的安全性和更好的疗效。所有的分析,综合成本和功效措施,表明dupilumab是优选的替代方案。具体来说,dupilumab的每个响应者分析成本,在第52周表现出67.0%的应答率,每个应答者14,209欧元是特别经济的。与24,999EUR的奥马珠单抗(36.2%的应答率)和31,863EUR的美泊利单抗(28.5%的应答率)的每个应答者的成本相比,这显示了更经济的概况。这些结果强调了dupilumab的潜力,不仅仅是临床结果,而且在经济理性方面,从而巩固其作为CRSwNP管理中有效和优选的替代方案的地位,在意大利NHS的背景下。
Chronic RhinoSinusitis with Nasal Polyps (CRSwNP) represents a condition mainly caused by the type 2 inflammation presence and marked by the existence of polyps within the nasal and paranasal sinuses. The standard of care includes intranasal steroids, additional burst of systemic steroids, if needed, and surgery. However, recurrence is common, especially among patients with comorbid type 2 inflammatory diseases. Recently, biological drugs, addressing the underlying cause of the disease, have been approved in Italy (dupilumab, omalizumab, and mepolizumab). A Health Technology Assessment was conducted to define multidimensional impact, assuming Italian NHS perspective and a 12-month time horizon. The EUnetHTA Core Model was deployed, using the following methods to analyze the domains: (i) literature evidence; (ii) administration of semi-structured questionnaires to 17 healthcare professionals; (iii) health economics tools to define the economic sustainability for the system. Evidence from NMA and ITC showed a more favorable safety profile and better efficacy for dupilumab compared with alternative biologics. All the analyses, synthesizing cost and efficacy measures, showed that dupilumab is the preferable alternative. Specifically, the cost per responder analysis for dupilumab, exhibiting a 67.0% response rate at Week 52, is notably economical at 14,209EUR per responder. This presents a more economical profile compared with the cost per responder for omalizumab (36.2% response rate) at 24,999EUR and mepolizumab (28.5% response rate) at 31,863EUR. These results underscore dupilumab\'s potential, not merely in terms of clinical outcomes, but also in terms of economic rationality, thereby solidifying its status as a valid and preferrable alternative in the management of CRSwNP, in the context of the Italian NHS.