Rhinosinusitis cost-effectiveness of therapy
Cost effectiveness of medical therapy and surgery is determined depending on the patients severity of disease. The cost effectiveness of biologic therapies needs more comprehensive research and is yet to be investigated.
Cost-effectiveness of Therapy
Medical therapy vs. Surgery
Current literature suggests that in patients with refractory chronic rhinosinusitis endoscopic sinus surgery(ESS) is superior to continued medical therapy in terms of symptom relief, quality of life and cost effectiveness with reported incremental cost effectiveness ratio (ICER) of five to thirteen thousand dollars per quality adjusted life year (QALY). Medical therapy mostly helps maintain the quality of life and health-state utility of the patients.
Biologic therapies such as mepolizumab, omalizumab and dupilumab are recently introduced as alternative therapies for sever cases of chronic rhinosinusitis. To date, there has been insufficient evidence in the literature regarding their health care, social and economic cost effectiveness. It is suggested that use of biologic agents could prevent recurrence of the disease, and subsequently decrease the direct and indirect costs of the surgery. On the other hand the their high cost and need for multiple visits to the health care provider, should be considered. Thus, it is not easy to determine the cost-effectiveness of biologic agents in treatment of chronic rhinosinusitis and further prospective research with longer follow-up period is required.
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