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[膀胱过度活动症:社会和经济视角]

[Overactive bladder syndrome: the social and economic perspective].

作者信息

Sacco Emilio, Bientinesi Riccardo, Marangi Francesco, D'Addessi Alessandro, Racioppi Marco, Gulino Gaetano, Pinto Francesco, Totaro Angelo, Bassi Pierfrancesco

机构信息

Clinica Urologica, Dipartimento di Scienze chirurgiche, Policlinico Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma - Italia.

出版信息

Urologia. 2011 Oct-Dec;78(4):241-56. doi: 10.5301/RU.2011.8886.

Abstract

Overactive bladder syndrome (OAB) is a highly prevalent condition associated with a significant impairment of patients' Quality of Life (QoL) because of its adverse effects on social, sexual, interpersonal, and professional functions. Cost-of-illness analyses showed the huge economic burden related to OAB for patients, public healthcare systems, and society, secondary to both direct and indirect costs. These types of cost analyses, however, exclude intangible costs related to QoL impairment. Recently, many novel therapies have been introduced, arising the need to apply the modern methodology of Health Technology Assessment (HTA) to new therapies in order to evaluate objectively their value in terms of both improvement in length/Quality of Life and costs. By producing information on the clinical, economic, organizational, social and ethical impact of health technologies, HTA has been used worldwide to inform decision makers at different levels in health systems. The HTA approach demonstrated, worldwide, to be a useful approach to increase the level of appropriateness in the use of medical technology and, as a consequence of that, of resources. Health utilities are instruments that allow a measurement of QoL and its integration in the economic evaluation using the Quality-of-life-Adjusted-Life-Years (QALYs) model and cost-utility analysis. The development of suitable instruments for quantifying utility in the specific group of OAB patients is vitally important to extend the application of cost-utility analysis in OAB and to guide healthcare resources allocation for this disorder. Studies are required to define the cost-effectiveness of available pharmacological and non-pharmacological therapy options.

摘要

膀胱过度活动症(OAB)是一种高度普遍的病症,因其对社交、性、人际和职业功能产生不利影响,会严重损害患者的生活质量(QoL)。疾病成本分析表明,由于直接和间接成本,OAB给患者、公共医疗系统和社会带来了巨大的经济负担。然而,这类成本分析并未将与生活质量受损相关的无形成本计算在内。最近,许多新型疗法被引入,因此有必要将现代卫生技术评估(HTA)方法应用于新疗法,以便从生活长度/质量改善和成本两方面客观评估其价值。通过提供有关卫生技术的临床、经济、组织、社会和伦理影响的信息,HTA已在全球范围内被用于为卫生系统中不同层面的决策者提供参考。在全球范围内,HTA方法已证明是一种有用的方法,可提高医疗技术使用的适当性水平,进而提高资源使用的适当性水平。健康效用是一种工具,可使用生活质量调整生命年(QALY)模型和成本效用分析来衡量生活质量并将其纳入经济评估。开发适用于量化OAB患者特定群体效用的工具对于扩大成本效用分析在OAB中的应用以及指导该疾病的医疗资源分配至关重要。需要开展研究以确定现有药物和非药物治疗方案的成本效益。

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