Bayer HealthCare Pharmaceuticals, São Paolo, Brazil.
Value Health. 2011 Jul-Aug;14(5 Suppl 1):S93-5. doi: 10.1016/j.jval.2011.05.008.
The aim of this study was to investigate the relationship between symptom severity, cost, and impairment in women with moderate/severe premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) in a Latin American setting.
A model was constructed based on analysis of an observational dataset. Data were included from four Latin American countries. Responder-level data were analysed according to four categories of symptom severity: Category 1 comprised Daily Record of Severity of Problems score 21 to 41.9, Category 2 score was 42 to 62.9, Category 3 score was 63 to 83.9, and Category 4 was a score of 84 or higher. Burden was estimated in terms of impact on job and activities using the modified work productivity and impairment questionnaire and affect on quality of life using the SF-12 questionnaire. Costs were estimated in Brazilian reals from a Brazilian private health care and societal perspective. The outputs of the analysis were estimates of burden, mean annual cost and affect on quality of life (as measured by quality adjusted life years) by symptom severity. Confidence intervals around key outcomes were generated through nonparametric bootstrapping.
Analysis suggests a significant cost burden associated with moderate/severe PMS and PMDD with mean per patient annual costs estimated at 1618 BRL (95% confidence interval 957-2,481). Although the relationship between cost, quality of life, and severity was not clear, analysis showed a consistent relationship between disease severity and measures of disease burden (job and daily activity). Burden on activities increased with disease severity.
Our analysis, conducted from a Latin American perspective, suggests a significant burden and an increasing impairment associated with moderate/severe PMS and PMDD.
本研究旨在探讨拉丁美洲地区中重度经前期综合征（PMS）或经前期烦躁障碍（PMDD）女性患者的症状严重程度、成本和功能障碍之间的关系。
根据观察性数据集的分析结果构建模型。数据来自拉丁美洲的四个国家。根据四个严重程度类别对应答者水平的数据进行分析：类别 1 包括每日问题严重程度记录评分 21 至 41.9，类别 2 评分为 42 至 62.9，类别 3 评分为 63 至 83.9，类别 4 评分为 84 或更高。使用改良工作生产力和障碍问卷评估对工作和活动的影响，使用 SF-12 问卷评估对生活质量的影响，从而估算负担。从巴西私人医疗保健和社会角度估算成本，以巴西雷亚尔表示。分析结果为按症状严重程度估算的负担、平均年度成本和对生活质量的影响（以质量调整生命年来衡量）。通过非参数自举法生成关键结果的置信区间。
分析表明，中重度 PMS 和 PMDD 与患者人均年成本相关，估计为 1618 雷亚尔（95%置信区间 957-2481）。尽管成本、生活质量和严重程度之间的关系不明确，但分析表明疾病严重程度与疾病负担（工作和日常活动）测量之间存在一致关系。疾病严重程度越高，活动负担越大。
从拉丁美洲的角度进行的分析表明，中重度 PMS 和 PMDD 会导致显著的负担和日益严重的功能障碍。
