Stelmach Iwona, Korzeniewska Aleksandra, Stelmach Włodzimierz
Oddział Kliniczny Interny Dzieciecej i Alergologii IP UM w Lodzi.
Pneumonol Alergol Pol. 2004;72(9-10):415-9.
Life expectancy of cystic fibrosis (CF) patients has improved following the introduction of modem therapies. Length of life has been most important determinant of cost of medical care in each population. The aim of this study was to evaluate the cost of pharmacologic treatment and their determinants served by patients and medical insurance. Medical records of our CF center patients from year 2003 were analysed. The annual cost of pharmacologic treatment in our patients in 2003 averaged PLN 26595.91; of total costs 74% were from DNase, 7% from drugs classified as "other", 6.2% from pancreatic enzymes. Individual annual costs served by patients averaged from PLN 979.67 to 10805.57 (mean PLN 6059.63). Mean annual cost "per patient" served by medical insurance averaged PLN 26595.91; 70% of costs were from DNase, 15% from inhaled corticosteroids and bronchodilators. 68% of drug costs were served by medical insurance, 32% by patient. We found significant correlation between cost served by patients (p1), by medical insurance (p2) and age (p1, p2<0.0001) and severity of disease--defined based on percent expected FEV1 (p1=0.006; p2=0.001). Severity of disease and patients age were important determinants of pharmacologic treatment cost in CF patients.
随着现代疗法的引入，囊性纤维化（CF）患者的预期寿命有所提高。在每个人口中，寿命长短一直是医疗费用的最重要决定因素。本研究的目的是评估药物治疗的成本及其由患者和医疗保险承担的决定因素。分析了我们CF中心2003年患者的病历。2003年我们患者的药物治疗年度成本平均为26595.91波兰兹罗提；总成本的74%来自脱氧核糖核酸酶（DNase），7%来自归类为“其他”的药物，6.2%来自胰酶。患者承担的个人年度成本平均从979.67波兰兹罗提到10805.57波兰兹罗提（平均6059.63波兰兹罗提）。医疗保险承担的“每位患者”平均年度成本为26595.91波兰兹罗提；70%的成本来自DNase，15%来自吸入性皮质类固醇和支气管扩张剂。68%的药物成本由医疗保险承担，32%由患者承担。我们发现患者承担的成本（p1）、医疗保险承担的成本（p2）与年龄（p1、p2<0.0001）以及基于预计第一秒用力呼气量百分比定义的疾病严重程度之间存在显著相关性（p1=0.006；p2=0.001）。疾病严重程度和患者年龄是CF患者药物治疗成本的重要决定因素。
