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幼年特发性关节炎和家族性地中海热的经济影响。

Economic impact of juvenile idiopathic arthritis and familial Mediterranean fever.

机构信息

Department of Pediatric Rheumatology, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey.

出版信息

Rheumatol Int. 2012 Jul;32(7):1955-62. doi: 10.1007/s00296-011-1894-y. Epub 2011 Apr 3.

Abstract

The aim of the study was to determine the economical impact of juvenile idiopathic arthritis (JIA) and familial Mediterranean fever (FMF) in Turkey. A total of 100 patients (69 F/31 M) with JIA and 100 with FMF (68 F/32 F) who were consecutively seen in the outpatient clinic of the pediatric rheumatology department at Cerrahpasa Medical School between August 2008 and January 2009 were studied. Cost data were collected through a questionnaire filled out by the parents. The mean age (JIA: 11 ± 5 years; FMF:12 ± 4 years) and mean disease duration (JIA:5 ± 3 years; FMF: 4 ± 3 years) of the patients were similar. JIA patients were assigned to 5 subtypes (polyarticular: n = 45, oligoarticular: n = 30, systemic onset: n = 13, psoriatic: n = 6, and enthesopathy-related JIA: n = 6). Forty-nine percent of the patients with JIA were treated with anti-TNF drugs and 61% with DMARDs. All patients with FMF were using colchicine. The total annual cost of JIA (3,994 ± 4,101) was considerably higher than that of FMF (162 ± 77) (P < 0.001). Medication fee was the major determinant of total costs in both diseases constituting 85% in JIA and 39% in FMF. Among the subtypes of JIA, total annual costs were the highest among patients with polyarticular type (6,045 ± 4,078). Medications especially anti-TNF drugs were the major contributor among all determinants of costs in JIA. The low costs of health care system and prominent changes in the health care policies for the last 5 years in Turkey might have played role in our findings.

摘要

本研究旨在评估幼年特发性关节炎(JIA)和家族性地中海热(FMF)在土耳其的经济影响。2008 年 8 月至 2009 年 1 月期间,我们连续在切拉庞萨医学院儿科风湿病科的门诊对 100 名 JIA 患者(69 名女性/31 名男性)和 100 名 FMF 患者(68 名女性/32 名男性)进行了研究。通过家长填写的问卷收集成本数据。患者的平均年龄(JIA:11 ± 5 岁;FMF:12 ± 4 岁)和平均病程(JIA:5 ± 3 年;FMF:4 ± 3 年)相似。JIA 患者分为 5 个亚型(多关节炎:n = 45,少关节炎:n = 30,全身型:n = 13,银屑病关节炎:n = 6,附着点相关关节炎:n = 6)。49%的 JIA 患者接受 TNF 拮抗剂治疗,61%接受 DMARD 治疗。所有 FMF 患者均使用秋水仙碱。JIA 的年总费用(3,994 ± 4,101)明显高于 FMF(162 ± 77)(P < 0.001)。药物费用是两种疾病总费用的主要决定因素,在 JIA 中占 85%,在 FMF 中占 39%。在 JIA 的各亚型中,多关节炎型患者的年总费用最高(6,045 ± 4,078)。药物,尤其是 TNF 拮抗剂,是 JIA 所有费用决定因素中的主要因素。土耳其过去 5 年来医疗保健系统成本低和医疗保健政策的显著变化可能对我们的发现产生了影响。

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