Laas K, Peltomaa R, Kautiainen H, Puolakka K, Leirisalo-Repo M
Division of Rheumatology, Department of Medicine, Helsinki University Central Hospital, Kasarmikatu 11-13, PO Box 263, FIN-00029 HUS, Finland.
Ann Rheum Dis. 2006 Jul;65(7):924-8. doi: 10.1136/ard.2005.041574. Epub 2005 Dec 8.
To evaluate medical and work disability costs for patients with chronic inflammatory joint disease during one year before and one year after institution of infliximab treatment in routine clinical practice.
Starting from 1999, clinical and laboratory variables for patients treated with biological agents for inflammatory rheumatic diseases were systematically recorded at Helsinki University Central Hospital. From this database clinical information was collected on 96 patients in whom infliximab was started during the period 1999 to 2001. Economic analyses were based on costs incurred because of outpatient and inpatient visits, orthopaedic operations, drugs used, and days on sickness or rehabilitation allowance. Medical and work disability costs were calculated separately for the one year period before (period I) and the one year period after institution of infliximab (period II).
Of the study group of 96 patients (arthritis duration 16 years (range 3 to 43)), 74 completed one year of infliximab treatment. Their clinical and laboratory variables improved significantly. The mean increase in medical costs during period II was euro12 015 (95% confidence interval, 6496 to 18,076). A minimal decrease in work disability costs occurred-mean decrease euro130 (-1268 to 1072).
One year treatment with infliximab in patients with longstanding aggressive arthritis showed a good clinical effect but raised medical costs significantly. Work disability costs failed to show a substantial decrease. Starting infliximab in the earlier stages of chronic arthritis could in the long term prevent work disability and thus decrease the total cost to society.
评估在常规临床实践中，英夫利昔单抗治疗开始前一年及开始后一年，慢性炎症性关节病患者的医疗和工作残疾成本。
从1999年开始，赫尔辛基大学中心医院系统记录接受生物制剂治疗的炎性风湿性疾病患者的临床和实验室变量。从该数据库中收集了1999年至2001年期间开始使用英夫利昔单抗的96例患者的临床信息。经济分析基于门诊和住院就诊、骨科手术、所用药物以及病假或康复津贴天数所产生的费用。分别计算英夫利昔单抗治疗开始前一年（时期I）和开始后一年（时期II）的医疗和工作残疾成本。
在96例研究组患者中（关节炎病程16年（范围3至43年）），74例完成了一年的英夫利昔单抗治疗。他们的临床和实验室变量有显著改善。时期II期间医疗费用的平均增加为12015欧元（95%置信区间，6496至18076）。工作残疾成本有极小幅度的下降——平均下降130欧元（-1268至1072）。
长期侵袭性关节炎患者接受一年的英夫利昔单抗治疗显示出良好的临床效果，但显著增加了医疗费用。工作残疾成本并未大幅下降。在慢性关节炎的早期阶段开始使用英夫利昔单抗，从长远来看可以预防工作残疾，从而降低社会总成本。
