Le Pen Claude, Reygrobellet Camille, Gérentes Isabelle
Aremis Consultants, 10, rue Beffroy, 92200 Neuilly-sur-Seine, France.
Joint Bone Spine. 2005 Dec;72(6):567-70. doi: 10.1016/j.jbspin.2005.01.011. Epub 2005 Jun 8.
Osteoarthritis is the most common musculoskeletal disease, with about 9-10 million patients in France including 4.6 million with symptoms. The objective of the COART France study is to evaluate the cost of osteoarthritis in France from the societal point of view and to compare the results to those obtained in 1993 using the same methodology.
The cost of osteoarthritis was evaluated using the macroeconomic approach. Direct costs were estimated from healthcare resource use (physician visits, drug prescriptions, and hospital admissions) and indirect costs from doctor-prescribed sick-leave durations.
Direct costs of osteoarthritis in 2002 exceeded 1.6 billion Euros, contributing about 1.7% of expenses of the French health insurance system, which covers all residents of France regardless of employment or documentation status. Hospital admissions were the greatest single contributor to direct costs, with more than 800 million Euros. Osteoarthritis led to 13 million physician visits, during which 570 million Euros worth of medications were prescribed. The 156% increase in direct medical costs compared to 1993 was chiefly related to an increase in the number of patients (+54%); the cost increase per patient was only 2.5% per year.
Despite the large increase in the number of treated patients and the development of new costly medications, the rise in the cost of managing osteoarthritis seems well contained. The aging of the population, development of new technologies, and increasing patient expectations will probably govern the future economic impact of osteoarthritis, which remains a major public health burden.
骨关节炎是最常见的肌肉骨骼疾病,在法国约有900万至1000万患者,其中460万出现症状。法国COART研究的目的是从社会角度评估法国骨关节炎的成本,并将结果与1993年使用相同方法获得的结果进行比较。
采用宏观经济方法评估骨关节炎的成本。直接成本根据医疗资源使用情况(就诊、药物处方和住院)估算,间接成本根据医生开具病假的时长估算。
2002年骨关节炎的直接成本超过16亿欧元,约占法国医疗保险系统费用的1.7%,该系统覆盖法国所有居民,无论其就业或文件状态如何。住院是直接成本的最大单一贡献因素,超过8亿欧元。骨关节炎导致1300万人次就诊,期间开出了价值5.7亿欧元的药物。与1993年相比,直接医疗成本增长了156%,主要与患者数量增加(+54%)有关;每位患者的成本每年仅增长2.5%。
尽管接受治疗的患者数量大幅增加,且出现了新的昂贵药物,但骨关节炎管理成本的上升似乎得到了很好的控制。人口老龄化、新技术的发展以及患者期望的提高可能会决定骨关节炎未来的经济影响,而骨关节炎仍然是一个主要的公共卫生负担。