Suárez Carmen, Abadía Carmen, Echevarria Amaya
Hospital de la Princesa, Madrid, España.
Med Clin (Barc). 2009 Sep;132 Suppl 2:41-3. doi: 10.1016/S0025-7753(09)71753-1.
The REACH registry includes patients from 44 countries with established atherosclerotic disease or at risk of this disease (coronary artery disease [CAD], cerebrovascular disease [CVD] and or peripheral artery disease [PAD]). The country with the largest population included in the registry was the United States, representing 38% of the total number of patients. Spain represented 3.7%. A comparative analysis of the populations from both countries as well as of the clinical management of this disease and its cost was performed. To calculate the mean total costs, drug costs, the costs of hospitalization due to vascular causes and the costs of loss of work productivity were taken into account. One of the most important results obtained after analyzing the REACH registry was the discovery of data showing the economic impact of PAD in patients with CAD or CVD. Patients with more than one diseased vascular bed had a higher associated healthcare cost due to an increase in both drug costs and hospitalization costs. Indirect costs could not be estimated for all groups. The differences in total mean costs between treating polyvascular disease and treating a single diseased vascular bed were much higher in the United States for patients with CAD + PAD vs. CAD and were much higher in Spain for patients with CVD + PAD vs. CVD. Analysis of the results of the REACH registry allows us to conclude that the presence of PAD together with CAD or CVD worsens patients' prognosis, which translates into a substantial increase in the cost of treatment, representing a greater economic burden for the Spanish national health system.
REACH注册研究纳入了来自44个国家的患有已确诊动脉粥样硬化疾病或有患此病风险(冠状动脉疾病[CAD]、脑血管疾病[CVD]和/或外周动脉疾病[PAD])的患者。注册研究中纳入人口最多的国家是美国,占患者总数的38%。西班牙占3.7%。对两国的人群以及该疾病的临床管理及其成本进行了比较分析。为计算平均总成本,考虑了药物成本、血管性病因导致的住院成本以及工作生产力损失成本。分析REACH注册研究后获得的最重要结果之一是发现了显示PAD对CAD或CVD患者经济影响的数据。患有多个病变血管床的患者因药物成本和住院成本增加而相关医疗保健成本更高。并非所有组都能估计间接成本。在美国,CAD + PAD患者与CAD患者相比,治疗多血管疾病和治疗单个病变血管床之间的总平均成本差异要大得多;在西班牙,CVD + PAD患者与CVD患者相比,这种差异要大得多。对REACH注册研究结果的分析使我们能够得出结论,PAD与CAD或CVD并存会使患者预后恶化,这转化为治疗成本大幅增加,给西班牙国家卫生系统带来更大的经济负担。