Jason Sanders, Matthew Greenhawt, John Oppenheimer, Aikaterini Anagnostou, Marcus S Shaker
{"title":"基于价值的护理过敏-免疫学:超越质量调整生命年。","authors":"Jason Sanders, Matthew Greenhawt, John Oppenheimer, Aikaterini Anagnostou, Marcus S Shaker","doi":"10.2500/aap.2025.46.250015","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background:</b> Value-based health care in the field of allergy/immunology must be informed by multiple factors, including costs (direct and indirect), outcomes, and the patient experience. <b>Objective:</b> We review features that define value-based health care and discuss a perspective that considers cost-effective care beyond the quality-adjusted life year (QALY). <b>Methods:</b> A narrative review and synthesis of the literature was leveraged to advance an understanding of health-care delivery that considers shared decision-making, health-economic outcomes, and the patient experience. <b>Results:</b> The patient and family experience of health and wellness must be considered carefully when interpreting health-economic evaluations. Health-state utilities consider trade-offs for wellness under conditions of risk and are used to inform QALYs for a myriad of disease states. Cost-effectiveness of medical therapies relates to trade-offs that are considered for populations, but these metrics can be translated holistically to inform health-care decisions for patients if considered contextually. In the case of food allergy, omalizumab would likely not be cost-effective on an individual level (incremental cost-effectiveness ratio, $573,698/QALY), but for those individuals with a high utility impairment, or, if considered from the perspective of a family unit, may be a more attractive therapy from a health-economic point of view. <b>Conclusion:</b> The balance between health and disease is such that there is always more disease than can be treated at any given moment, and both money and time can only be spent once. Because choice is inevitable, health-economic analysis can help inform clinical care. Still, translating population-level cost-effectiveness to individuals is challenging and decisions must be tailored to each patient and context.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 3","pages":"165-167"},"PeriodicalIF":2.6000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Value-based care in allergy-immunology: Beyond the quality-adjusted life year.\",\"authors\":\"Jason Sanders, Matthew Greenhawt, John Oppenheimer, Aikaterini Anagnostou, Marcus S Shaker\",\"doi\":\"10.2500/aap.2025.46.250015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background:</b> Value-based health care in the field of allergy/immunology must be informed by multiple factors, including costs (direct and indirect), outcomes, and the patient experience. <b>Objective:</b> We review features that define value-based health care and discuss a perspective that considers cost-effective care beyond the quality-adjusted life year (QALY). <b>Methods:</b> A narrative review and synthesis of the literature was leveraged to advance an understanding of health-care delivery that considers shared decision-making, health-economic outcomes, and the patient experience. <b>Results:</b> The patient and family experience of health and wellness must be considered carefully when interpreting health-economic evaluations. Health-state utilities consider trade-offs for wellness under conditions of risk and are used to inform QALYs for a myriad of disease states. Cost-effectiveness of medical therapies relates to trade-offs that are considered for populations, but these metrics can be translated holistically to inform health-care decisions for patients if considered contextually. In the case of food allergy, omalizumab would likely not be cost-effective on an individual level (incremental cost-effectiveness ratio, $573,698/QALY), but for those individuals with a high utility impairment, or, if considered from the perspective of a family unit, may be a more attractive therapy from a health-economic point of view. <b>Conclusion:</b> The balance between health and disease is such that there is always more disease than can be treated at any given moment, and both money and time can only be spent once. Because choice is inevitable, health-economic analysis can help inform clinical care. Still, translating population-level cost-effectiveness to individuals is challenging and decisions must be tailored to each patient and context.</p>\",\"PeriodicalId\":7646,\"journal\":{\"name\":\"Allergy and asthma proceedings\",\"volume\":\"46 3\",\"pages\":\"165-167\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Allergy and asthma proceedings\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2500/aap.2025.46.250015\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Allergy and asthma proceedings","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2500/aap.2025.46.250015","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ALLERGY","Score":null,"Total":0}
Value-based care in allergy-immunology: Beyond the quality-adjusted life year.
Background: Value-based health care in the field of allergy/immunology must be informed by multiple factors, including costs (direct and indirect), outcomes, and the patient experience. Objective: We review features that define value-based health care and discuss a perspective that considers cost-effective care beyond the quality-adjusted life year (QALY). Methods: A narrative review and synthesis of the literature was leveraged to advance an understanding of health-care delivery that considers shared decision-making, health-economic outcomes, and the patient experience. Results: The patient and family experience of health and wellness must be considered carefully when interpreting health-economic evaluations. Health-state utilities consider trade-offs for wellness under conditions of risk and are used to inform QALYs for a myriad of disease states. Cost-effectiveness of medical therapies relates to trade-offs that are considered for populations, but these metrics can be translated holistically to inform health-care decisions for patients if considered contextually. In the case of food allergy, omalizumab would likely not be cost-effective on an individual level (incremental cost-effectiveness ratio, $573,698/QALY), but for those individuals with a high utility impairment, or, if considered from the perspective of a family unit, may be a more attractive therapy from a health-economic point of view. Conclusion: The balance between health and disease is such that there is always more disease than can be treated at any given moment, and both money and time can only be spent once. Because choice is inevitable, health-economic analysis can help inform clinical care. Still, translating population-level cost-effectiveness to individuals is challenging and decisions must be tailored to each patient and context.
期刊介绍:
Allergy & Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists. The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma. Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.