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美国患者骨关节炎相关的医疗保健费用。

Healthcare costs associated with osteoarthritis in US patients.

机构信息

Eli Lilly and Company, Indianapolis, IN, USA.

出版信息

Pain Pract. 2012 Nov;12(8):633-40. doi: 10.1111/j.1533-2500.2012.00535.x. Epub 2012 Feb 6.

Abstract

BACKGROUND

Osteoarthritis is a chronic debilitating condition affecting many adults in the United States. This study was to compare pharmacologic treatments and costs for newly diagnosed and existing osteoarthritis patients to assess unmet medication treatment needs and economic burden.

METHODS

This retrospective analysis of de-identified medical and pharmacy insurance claims from the MarketScan(®) databases identified adult patients with an osteoarthritis claim in 2007. The date of the first osteoarthritis claim in 2007 served as the index. Patients were stratified into newly diagnosed and existing cohorts, based on the presence of osteoarthritis claim(s) over the 12-month pre-index period. Utilization of pain-related medications and healthcare costs was assessed in the 12-month postindex period. Multivariate analysis was conducted to adjust costs controlling for cross-cohort differences.

RESULTS

Newly diagnosed osteoarthritis patients (n = 134,584) were younger (66.0 vs. 68.0, P < 0.001), had a higher proportion of men (37.4% vs. 33.9%, P < 0.001) but lower rates of comorbidities than existing patients (n = 123,653). Significantly higher proportions of newly diagnosed patients had an inpatient admission and outpatient office visit. Higher proportions of existing patients utilized a majority of the medication classes examined. Total adjusted osteoarthritis-related costs for newly diagnosed patients were $6,811 annually (95% confidence interval [CI] $6,743 to $6,887), compared to $6,407 (95% CI $6,327 to $6,477) for existing patients. Costs of pain-related prescription drugs associated with osteoarthritis were $965 (95% CI $955 to $975) among new patients, less than the $1,117 (95% CI $1,107 to $1,129) among existing patients.

CONCLUSION

Newly diagnosed osteoarthritis patients incurred higher annual costs, but lower pain-related prescription drug costs in the year following diagnosis than patients with existing osteoarthritis.

摘要

背景

骨关节炎是一种影响美国许多成年人的慢性致残疾病。本研究旨在比较新诊断和现有骨关节炎患者的药物治疗和费用,以评估未满足的药物治疗需求和经济负担。

方法

本回顾性分析从 MarketScan(®)数据库中提取的去标识医疗和药房保险理赔数据,确定了 2007 年有骨关节炎理赔的成年患者。2007 年首次骨关节炎理赔日期作为索引。根据 12 个月索引前期间是否存在骨关节炎理赔,将患者分为新诊断和现有队列。在索引后 12 个月评估疼痛相关药物的使用和医疗保健费用。进行多变量分析以控制跨队列差异调整成本。

结果

新诊断的骨关节炎患者(n = 134584)年龄较小(66.0 岁比 68.0 岁,P < 0.001),男性比例较高(37.4%比 33.9%,P < 0.001),但合并症发生率低于现有患者(n = 123653)。新诊断患者的住院入院和门诊就诊比例明显较高。更多的现有患者使用了大部分检查的药物类别。新诊断患者的骨关节炎相关总调整费用为每年 6811 美元(95%置信区间 [CI] 6743 美元至 6887 美元),而现有患者为每年 6407 美元(95% CI 6327 美元至 6477 美元)。新患者与骨关节炎相关的疼痛相关处方药费用为 965 美元(95% CI 955 美元至 975 美元),低于现有患者的 1117 美元(95% CI 1107 美元至 1129 美元)。

结论

与患有现有骨关节炎的患者相比,新诊断的骨关节炎患者在诊断后一年的年成本较高,但疼痛相关处方药费用较低。

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