Lifetime Work Productivity Gains Among Patients with Chronic Rhinosinusitis with Nasal polyps (CRSwNP) Treated with EDS‐FLU: 853

Abstract

Fulton F. Velez, MD, MS, MBA, Harry J. Sacks, MD, FAAP, John C. Messina, Jr, PharmD, Victoria Dennison, Nathaniel Smith, PhD, Daniel C. Malone, RPh, PhD, FAMCP, and Ramy A. Mahmoud, MD, MPH; OptiNose US, Inc., Yardley, PA, Maple Health Group, LLC, Bronx, NY, Strategic Therapeutics, LLC., Oro Valley. RATIONALE: Chronic rhinosinusitis with/without nasal polyps (CRSwNP/CRSsNP) is a debilitating inflammatory disorder commonly diagnosed in working age adults, and is characterized by significant morbidity and poor outcomes with standard medical therapy. CRS affects approximately 15% of adults, generating ;$60B in lost productivity annually. In two randomized controlled trials in CRSwNP (NAVIGATE I/ II), treatment with the exhalation delivery system with fluticasone (EDSFLU; XHANCE ), was associated with a 52.7% improvement in self-reported work productivity. We model the long-term impact of EDS-FLU treatment on work productivity in specialist-treated CRSwNP patients from a societal perspective. METHODS: Using the human capital approach, a 30-year Markov model was developed comparing EDS-FLU vs. standard medical therapy. Mean cohort age was 40 years. Health state transition probabilities and lost productivity associated with health state and sinonasal surgery were obtained from NAVIGATE I/II and published literature. Costs were discounted to 2018 dollars. A probabilistic sensitivity analysis was conducted. RESULTS: Over 30 years, standard medical therapy was associated with 2.9 years with $134,823 in productivity losses per specialist-treated patient, while treatment with EDS-FLU was associated with productivity losses of 1.6 years, worth $74,978. If EDS-FLU replaced current medical therapy, the societal savings would be $19.5B. The model was most sensitive to health state transition probabilities, and the proportion of patients with severe disease at baseline. CONCLUSIONS: In this model, EDS-FLU treatmentwas associatedwith 1.3 productive years gained per patient over 30 years vs. standard medical treatment, with estimated societal savings of nearly $20B.