Semmelweis University, University Pharmacy Department of Pharmacy Administration, Hőgyes Endre u. 7-9, Budapest 1092, Hungary.
Rheumatol Int. 2012 Apr;32(4):963-9. doi: 10.1007/s00296-010-1721-x. Epub 2011 Jan 18.
Biological treatments earn increasing significance in the treatment of rheumatoid arthritis (RA) but are associated with high incremental cost-effectiveness ratio compared to conventional antirheumatic treatments such as disease-modifying antirheumatic drugs. As the most important objective of medical technologies should be to increase life years and/or patients' health-related quality of life (HRQoL), measuring QoL and utility in RA patients treated with biological therapies is crucial. The objective of this study is to compare the utility and QoL of patients treated with biological (n = 85) and non-biological (n = 168) antirheumatic drugs in Hungary in a cross-sectional non-interventional study. A measure of impairment (Disease Activity Score (DAS)-28), QoL measure (EuroQol five Dimension (EQ-5D) Visual Analogue Scale (VAS), Rheumatoid Arthritis Quality of Life (RAQoL)) and utility measures (indirect: EQ-5D index, direct: time trade-off (TTO)) were applied using an interview method. The Pearson correlation was used to assess the strength of the relationship of different measures in the total study group (n = 253). The EQ-5D index (biological treatment: 0.608, non-biological treatment: 0.483; P = 0.012) and DAS-28 (biological treatment: 3.8, non-biological treatment: 4.5; P = 0.003) showed statistically significant difference between the two subcohorts after adjusting data by age, gender and disease duration. Our results indicate that patients on biological treatment have lower disease activity and higher utility; however, it was not statistically significant in all cases. According to our knowledge, TTO was not used previously in Hungarian RA patients. Utility data concerning biological treatments are essential for cost-utility models in health technology assessment reports for public reimbursement.
生物制剂在类风湿关节炎（RA）的治疗中越来越重要，但与传统的抗风湿治疗（如改善病情的抗风湿药物）相比，其增量成本效益比更高。由于医疗技术最重要的目标应该是增加患者的寿命和/或健康相关生活质量（HRQoL），因此，衡量接受生物治疗的 RA 患者的 QoL 和效用至关重要。本研究的目的是在一项横断面非干预性研究中比较匈牙利接受生物（n=85）和非生物（n=168）抗风湿药物治疗的患者的效用和 QoL。采用访谈法评估了损伤程度（疾病活动评分（DAS）-28）、QoL 测量（欧洲五维健康量表（EQ-5D）视觉模拟量表（VAS）、类风湿关节炎生活质量（RAQoL））和效用测量（间接：EQ-5D 指数，直接：时间权衡（TTO））。Pearson 相关系数用于评估总研究组（n=253）中不同测量值之间的关系强度。EQ-5D 指数（生物治疗：0.608，非生物治疗：0.483；P=0.012）和 DAS-28（生物治疗：3.8，非生物治疗：4.5；P=0.003）在调整年龄、性别和疾病持续时间后，两个亚组之间存在统计学显著差异。我们的结果表明，接受生物治疗的患者疾病活动度较低，效用较高；但并非所有情况下均具有统计学意义。据我们所知，TTO 以前在匈牙利 RA 患者中尚未使用。关于生物治疗的效用数据对于公共报销的卫生技术评估报告中的成本效益模型至关重要。
