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生物制剂引入前后日常临床实践中高需求银屑病的经济影响。

The economic impact of high-need psoriasis in daily clinical practice before and after the introduction of biologics.

机构信息

Department of Dermatology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6525 GL Nijmegen, the Netherlands.

出版信息

Br J Dermatol. 2010 Jun;162(6):1324-9. doi: 10.1111/j.1365-2133.2010.09693.x. Epub 2010 Feb 15.

Abstract

BACKGROUND

Although costs of biologics are high, effective treatment of patients with psoriasis may reduce the total health care costs, as it may limit the need for hospitalization.

OBJECTIVES

To investigate the economic impact of psoriasis, including direct costs, before and after the introduction of biologics, with special focus on hospitalized patients, treatment effectiveness and patient satisfaction with medication.

PATIENTS AND METHODS

A descriptive retrospective cohort study including 67 patients with high-need psoriasis was done. Direct costs were investigated for the biologic and pre-biologic period. Direct costs for a subgroup of hospitalized patients were analysed separately. Patient satisfaction with biologic treatment was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM) version II. Effectiveness of biologic therapy was investigated by means of the Psoriasis Area and Severity Index (PASI).

RESULTS

Mean total direct costs were €10,146 per patient per year (PPPY) in the pre-biologic treatment period, compared with €17,712 PPPY in the biologic treatment period. For six patients in the cohort, introduction of biologics led to a reduction of direct costs, as these patients did not need long hospitalizations. Treatment with biologics led to a decrease in PASI from 19·0 at the start of biologic therapy to 6·4 at analysis (66·4%). Patient satisfaction with biologics was high, indicated by a mean TSQM score of 77·8.

CONCLUSIONS

Introduction of biologic therapies may have cost-neutral or cost-saving effects for patients who otherwise require long hospitalization periods. Treatment with biologics proved effective and was accompanied by high satisfaction for the patients.

摘要

背景

尽管生物制剂的费用很高,但有效治疗银屑病患者可能会降低总体医疗保健成本,因为这可能会减少住院需求。

目的

调查银屑病的经济影响,包括生物制剂引入前后的直接成本,特别关注住院患者、治疗效果和患者对药物的满意度。

患者和方法

进行了一项描述性回顾性队列研究,纳入了 67 例高需求银屑病患者。调查了生物制剂和生物制剂前时期的直接成本。单独分析了住院患者亚组的直接成本。使用治疗药物满意度问卷 (TSQM) 版本 II 测量患者对生物治疗的满意度。通过银屑病面积和严重程度指数 (PASI) 调查生物治疗的有效性。

结果

在生物制剂治疗前时期,每位患者每年的总直接费用为 10146 欧元(PPPY),而在生物制剂治疗期间为 17712 欧元 PPPY。在队列中的 6 名患者中,由于这些患者不需要长期住院,因此引入生物制剂导致直接成本降低。生物治疗使 PASI 从生物治疗开始时的 19.0 下降到分析时的 6.4(66.4%)。患者对生物制剂的满意度很高,TSQM 平均得分为 77.8。

结论

对于需要长期住院治疗的患者,引入生物制剂治疗可能具有成本中性或节省成本的效果。生物治疗有效,并伴随着患者的高度满意度。

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