Healthcare Resource Use Among Patients With Chronic Rhinosinusitis With Nasal Polyps in the United Kingdom: Results of an Expert Elicitation Survey
Author(s)
Danny Gibson, MASc1, Santiago Zuluaga Sanchez, MSc2, Matthew Wallace, MPharm, MPH3, Emilija Veljanoska, MSc4, Agota Szende, PhD3.
1Market Access and Pricing, AstraZeneca, Cambridge, United Kingdom, 2Health Economics, Amgen, Uxbridge, United Kingdom, 3Market Access Consulting & HEOR, Fortrea, Leeds, United Kingdom, 4Market Access Consulting & HEOR, Fortrea, Munich, Germany.
1Market Access and Pricing, AstraZeneca, Cambridge, United Kingdom, 2Health Economics, Amgen, Uxbridge, United Kingdom, 3Market Access Consulting & HEOR, Fortrea, Leeds, United Kingdom, 4Market Access Consulting & HEOR, Fortrea, Munich, Germany.
OBJECTIVES: Quantify healthcare resource use (HRU) across the treatment pathway for patients with chronic rhinosinusitis with nasal polyps (CRSwNP) in the United Kingdom (UK), stratified by disease severity.
METHODS: Expert elicitation was conducted via semi-structured interviews with five Ear, Nose and Throat (ENT) consultant surgeons from England and Scotland, each with 12-35 years of clinical experience managing CRSwNP. Participants provided both qualitative insights and quantitative estimates on typical patient characteristics, treatment patterns, healthcare encounters, and resource utilization. NHS reference costs were applied to HRU data to estimate per-patient direct healthcare costs by severity level.
RESULTS: HRU increased with symptom severity. Median annual visits were 3 (range: 2-9) for mild, 7 (3-16) for moderate, and 13 (3-29) for severe CRSwNP cases, encompassing GP, ENT, immunology, pulmonology, rheumatology, specialist nurse, and A&E services. Endoscopy was universally performed at diagnosis, with biopsy (3%) and MRI (1%) reserved for suspected malignancy. Functional endoscopic sinus surgery (FESS) was identified as the predominant intervention for medically refractory disease, while polypectomy was employed in up to 25% of cases, based on polyp size and location, sinus symptom severity, patient status and local surgical availability. A two-week post-operative recovery period was recommended for FESS procedures. Total direct CRSwNP related healthcare costs were estimated separately for the initial year (including diagnosis) as £1,400, £1,877, and £2,981 for mild, moderate, and severe cases; and for subsequent years (monitoring only) as £612, £1,089, and £2,193, respectively. Surgical cases were costed at £3,987, including costs of surgery, ENT visit, CT scan, and endoscopy.
CONCLUSIONS: CRSwNP imposes a significant and increasing burden on UK healthcare resources as disease severity progresses. Surgical procedures in these patients account for the highest cost-related utilization. These findings highlight the importance of effective treatment strategies that may prevent or delay the need for surgical intervention.
METHODS: Expert elicitation was conducted via semi-structured interviews with five Ear, Nose and Throat (ENT) consultant surgeons from England and Scotland, each with 12-35 years of clinical experience managing CRSwNP. Participants provided both qualitative insights and quantitative estimates on typical patient characteristics, treatment patterns, healthcare encounters, and resource utilization. NHS reference costs were applied to HRU data to estimate per-patient direct healthcare costs by severity level.
RESULTS: HRU increased with symptom severity. Median annual visits were 3 (range: 2-9) for mild, 7 (3-16) for moderate, and 13 (3-29) for severe CRSwNP cases, encompassing GP, ENT, immunology, pulmonology, rheumatology, specialist nurse, and A&E services. Endoscopy was universally performed at diagnosis, with biopsy (3%) and MRI (1%) reserved for suspected malignancy. Functional endoscopic sinus surgery (FESS) was identified as the predominant intervention for medically refractory disease, while polypectomy was employed in up to 25% of cases, based on polyp size and location, sinus symptom severity, patient status and local surgical availability. A two-week post-operative recovery period was recommended for FESS procedures. Total direct CRSwNP related healthcare costs were estimated separately for the initial year (including diagnosis) as £1,400, £1,877, and £2,981 for mild, moderate, and severe cases; and for subsequent years (monitoring only) as £612, £1,089, and £2,193, respectively. Surgical cases were costed at £3,987, including costs of surgery, ENT visit, CT scan, and endoscopy.
CONCLUSIONS: CRSwNP imposes a significant and increasing burden on UK healthcare resources as disease severity progresses. Surgical procedures in these patients account for the highest cost-related utilization. These findings highlight the importance of effective treatment strategies that may prevent or delay the need for surgical intervention.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE503
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)