{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T09:01:40Z","timestamp":1793437300106,"version":"4.5.0"},"reference-count":57,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,4,3]],"date-time":"2020-04-03T00:00:00Z","timestamp":1585872000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Both endoscopic sinus surgery (ESS) and biologic therapies have shown effectiveness for medically\u2010refractory chronic rhinosinusitis with nasal polyps (CRSwNP) without severe asthma. The objective was to evaluate cost\u2010effectiveness of dupilumab versus ESS for patients with CRSwNP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Cohort\u2010style Markov decision\u2010tree economic model with a 36\u2010year time horizon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cohort of 197 CRSwNP patients who underwent ESS were compared with a matched cohort of 293 CRSwNP patients from the SINUS\u201024 and SINUS\u201052 Phase 3 studies who underwent treatment with dupilumab 300\u2009mg every 2\u2009weeks. Utility scores were calculated from the SNOT\u201022 instrument in both cohorts. Decision\u2010tree analysis and a 10\u2010state Markov model utilized published event probabilities and primary data to calculate long\u2010term costs and utility. The primary outcome measure was incremental cost per quality\u2010adjusted life year (QALY), which is expressed as an Incremental Cost Effectiveness Ratio. One\u2010way and probabilistic sensitivity analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The ESS strategy cost $50,436.99 and produced 9.80 QALYs. The dupilumab treatment strategy cost $536,420.22 and produced 8.95 QALYs. Because dupilumab treatment was more costly and less effective than the ESS strategy, it is dominated by ESS in the base case. One\u2010way sensitivity analyses showed ESS to be cost\u2010effective versus dupilumab regardless of the frequency of revision surgery and at any yearly cost of dupilumab above $855.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The ESS treatment strategy is more cost effective than dupilumab for upfront treatment of CRSwNP. More studies are needed to isolate potential phenotypes or endotypes that will benefit most from dupilumab in a cost\u2010effective manner.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      2C\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 131:E26\u2013E33, 2021\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.28648","type":"journal-article","created":{"date-parts":[[2020,4,3]],"date-time":"2020-04-03T12:26:22Z","timestamp":1585916782000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":169,"title":["Cost Utility Analysis of Dupilumab Versus Endoscopic Sinus Surgery for Chronic Rhinosinusitis With Nasal Polyps"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6687-788X","authenticated-orcid":false,"given":"George A.","family":"Scangas","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Harvard Medical School  Boston Massachusetts U.S.A."},{"name":"Department of Otolaryngology Massachusetts Eye and Ear  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8993-6355","authenticated-orcid":false,"given":"Arthur W.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan Y.","family":"Ting","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Indiana University  Indianapolis Indiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Metson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Harvard Medical School  Boston Massachusetts U.S.A."},{"name":"Department of Otolaryngology Massachusetts Eye and Ear  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Walgama","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark G.","family":"Shrime","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Harvard Medical School  Boston Massachusetts U.S.A."},{"name":"Department of Otolaryngology Massachusetts Eye and Ear  Boston Massachusetts U.S.A."},{"name":"Center for Global Surgery Evaluation Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2020-6386","authenticated-orcid":false,"given":"Thomas S.","family":"Higgins","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Louisville School of Medicine  Louisville Kentucky U.S.A."},{"name":"Rhinology, Sinus &amp; 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