{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T02:42:41Z","timestamp":1786243361136,"version":"build-2736575974"},"reference-count":16,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Rhinol\ufffdAllergy"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Biologic therapies for chronic rhinosinusitis with nasal polyps (CRSwNP) broaden options beyond endoscopic sinus surgery (ESS) and conventional medications. However, the short-term impact of biologic therapy on healthcare utilization relative to ESS is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare 12-month healthcare utilization and costs after biologic initiation versus ESS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the Atropos Health platform (2019-2024; \u223c66 million patients), adults with CRSwNP and \u226512-month follow-up who received treatment with ESS or an approved biologic were identified. After 1:1 propensity-score matching, 12-month outcomes were compared, including medication use, CRSwNP-related visits, subsequent sinus surgery, complications, and Current Procedural Terminology (CPT)-based costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 7519 ESS and 2084 biologic-treated eligible patients, 998 remained per arm after matching. Biologics and ESS patients had similar office (41.3% vs 38.7%; OR 0.90, 95% CI 0.77-1.07) and ED visit rates (2.0% vs 1.3%; OR 0.65, 95% CI 0.32-1.30). Subsequent sinus surgery was more frequent after biologics (3.6% vs 12.9%; OR 3.97, 95% CI 2.71-5.80). No significant differences were identified in CPT-based costs, complication rates, or steroid use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Within 1 year, ESS and biologic patients showed similar healthcare utilization, with the exception of subsequent sinus surgery rates, which were higher in biologic patients. These findings may guide shared decision-making and payer policy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19458924261475777","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T15:29:52Z","timestamp":1785943792000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Healthcare Utilization After Biologic Initiation for Chronic Rhinosinusitis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4895-2185","authenticated-orcid":false,"given":"Beau M.","family":"Idler","sequence":"first","affiliation":[{"name":"Stanford University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jananee","family":"Muralidharan","sequence":"additional","affiliation":[{"name":"Atropos Health, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin","family":"Hui","sequence":"additional","affiliation":[{"name":"Atropos Health, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1867-994X","authenticated-orcid":false,"given":"Noel F.","family":"Ayoub","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31881-1"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.31774"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/alr.23059"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/alr.23246"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2022.02.017"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28648"},{"issue":"4","key":"e_1_3_2_8_2","first-page":"495","article-title":"The extra cost of biologics as first-line treatment in uncontrolled chronic rhinosinusitis with nasal polyps with no previous sinus surgery is overwhelming: A budget impact analysis","volume":"63","author":"Fieux M","year":"2025","unstructured":"Fieux M, Margier J, Bartier S, et al. The extra cost of biologics as first-line treatment in uncontrolled chronic rhinosinusitis with nasal polyps with no previous sinus surgery is overwhelming: A budget impact analysis. Rhinology. 2025;63(4):495\u2013504.","journal-title":"Rhinology"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22936"},{"key":"e_1_3_2_10_2","unstructured":"Atropos Health https:\/\/www.atroposhealth.com\/atropos-evidence-network\/."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2011.568786"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/alr.23455"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.32063"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/19458924221147501"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2021.12.006"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/alr.23340"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2024.104368"}],"container-title":["American Journal of Rhinology &amp; Allergy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19458924261475777","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19458924261475777","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19458924261475777","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T01:46:16Z","timestamp":1786239976000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19458924261475777"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,5]]},"references-count":16,"alternative-id":["10.1177\/19458924261475777"],"URL":"https:\/\/doi.org\/10.1177\/19458924261475777","relation":{},"ISSN":["1945-8924","1945-8932"],"issn-type":[{"value":"1945-8924","type":"print"},{"value":"1945-8932","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,5]]},"article-number":"19458924261475777"}}