Biologics for chronic rhinosinusitis with nasal polyps: Economics and ethics

Lauren T Roland; Alan Regenberg; Amber U Luong; Sarah K Wise; Elina Toskala; Kent K Lam; Joshua M Levy; Christine B Franzese; Kristine Smith; Jean Kim

doi:10.1002/alr.22864

Biologics for chronic rhinosinusitis with nasal polyps: Economics and ethics

Int Forum Allergy Rhinol. 2021 Nov;11(11):1524-1528. doi: 10.1002/alr.22864. Epub 2021 Jul 11.

Authors

Affiliations

¹ Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA.
² Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, USA.
³ Department of Otolaryngology - Head and Neck Surgery, McGovern Medical School of the University of Texas Health Science Center at Houston, Houston, Texas, USA.
⁴ Department of Otolaryngology - Head and Neck Surgery, Emory University, Atlanta, Georgia, USA.
⁵ Department of Otolaryngology - Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
⁶ Department of Otolaryngology - Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, Virginia, USA.
⁷ Department of Otolaryngology - Head and Neck Surgery, University of Missouri, Columbia, Missouri, USA.
⁸ Department of Otolaryngology - Head and Neck Surgery, University of Manitoba, Winnipeg, Canada.
⁹ Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA.

PMID: 34250730
DOI: 10.1002/alr.22864

Abstract

Biologics have recently been approved for use in chronic rhinosinusitis with nasal polyps patients. While effective in controlling disease on subjective and objective short-term outcome measures, limited data suggest that biologics have the potential to be used long term. The current wholesale acquisition costs for biologics are quite high. Widespread, prolonged use of these medications may create a large burden to our healthcare system. Cost-effectiveness analyses, particularly for specific patient cohorts, are needed to determine appropriate use of these medications. The ethics of patient preference of various treatment options, counseling regarding side effect profiles, and healthcare economics also need to be addressed.

Keywords: chronic rhinosinusitis; medical therapy of chronic rhinosinusitis; rhinosinusitis.

MeSH terms

Biological Products* / therapeutic use
Chronic Disease
Humans
Nasal Polyps* / drug therapy
Rhinitis* / drug therapy
Sinusitis* / drug therapy

Substances

Biological Products