Yu Andrew P, Tang Jackson, Xie Jipan, Wu Eric Q, Gupta Shiraz R, Bao Yanjun, Mulani Parvez M
Analysis Group, Inc., 111 Huntington Avenue, 10th floor, Boston, MA 02199, USA.
Curr Med Res Opin. 2009 Oct;25(10):2429-38. doi: 10.1185/03007990903185557.
To evaluate health care utilization and costs for patients with psoriasis vs. the general population and by psoriasis severity.
Claims data were analyzed for adult patients with > or =1 diagnosis of psoriasis and continuous enrollment during the year of 2003 (case sample). A control sample was matched 2:1 on baseline demographic characteristics to the case sample. Case samples were further stratified by psoriasis severity based on treatment patterns. Outcomes were compared descriptively and by a multivariate two-part model to evaluate differences between the case vs. control groups and by psoriasis severity.
Outcomes included health care resource utilization and health care costs.
A total of 56,528 patients with psoriasis met the inclusion criteria. Patients with psoriasis had significantly greater total health care resource utilization, total medical resource utilization, and total drug utilization vs. the control sample (p < 0.0001). Compared with control patients, patients with psoriasis had significantly greater total health care costs ($5529 vs. $3509), including greater medical costs ($3925 vs. $2687) and drug costs ($1604 vs. $822; all p < 0.0001). Patients with moderate to severe psoriasis (n = 5248) had greater total health care costs vs. patients with mild psoriasis (n = 51,280) ($10,593 vs. $5011), including greater medical costs ($5854 vs. $3728) and drug costs ($4738 vs. $1283; all p < 0.0001). Multivariate analyses confirmed the increased utilization and costs in all comparisons.
The study limitations included limited generalizability of the findings beyond the study population, classification of disease severity based on treatment instead of clinical measures, and exclusion of out-of-pocket costs and indirect costs in the study.
Patients with psoriasis incur greater health care resource utilization and costs compared with the general population. Psoriasis severity is positively associated with increased health care resource utilization and costs.
评估银屑病患者与普通人群相比以及按银屑病严重程度划分的医疗保健利用情况和费用。
对2003年有≥1次银屑病诊断且持续参保的成年患者的理赔数据进行分析（病例样本）。根据基线人口统计学特征，以2:1的比例为病例样本匹配对照样本。病例样本根据治疗模式进一步按银屑病严重程度分层。通过描述性分析和多变量两部分模型比较结果，以评估病例组与对照组之间以及按银屑病严重程度划分的差异。
结局包括医疗保健资源利用情况和医疗保健费用。
共有56,528例银屑病患者符合纳入标准。与对照样本相比，银屑病患者的总医疗保健资源利用、总医疗资源利用和总药物利用显著更高（p < 0.0001）。与对照患者相比，银屑病患者的总医疗保健费用显著更高（5529美元对3509美元），包括更高的医疗费用（3925美元对2687美元）和药物费用（1604美元对822美元；均p < 0.0001）。中度至重度银屑病患者（n = 5248）的总医疗保健费用高于轻度银屑病患者（n = 51,280）（10,593美元对5011美元），包括更高的医疗费用（5854美元对3728美元）和药物费用（4738美元对1283美元；均p < 0.0001）。多变量分析证实了所有比较中利用情况和费用的增加。
研究局限性包括研究结果在研究人群之外的可推广性有限、基于治疗而非临床指标对疾病严重程度进行分类，以及研究中排除了自付费用和间接费用。
与普通人群相比，银屑病患者的医疗保健资源利用和费用更高。银屑病严重程度与医疗保健资源利用和费用的增加呈正相关。
