IMS Consulting Group, Barcelona, Spain.
Clin Drug Investig. 2012 Apr 1;32(4):235-45. doi: 10.2165/11599680-000000000-00000.
The cost of the therapeutic management of acromegaly depends on the selection of resources used, surgery and/or pharmacological treatment, by the specialist responsible for treatment, related to the characteristics of the patient and tumour. The objective of this work is to evaluate these costs for an illness that is rare but that is associated with a high morbidity in the context of routine clinical practice.
This was an epidemiological, prospective, naturalistic, multicentre study in Spain, in which 38 endocrinologists participated. Adult patients with acromegaly and a pituitary microadenoma or macroadenoma were included in the study. Patients were assigned, according to first-line treatment, to the following two groups: surgery first-line group (surgery in the 6 months before inclusion or during the follow-up period) and pharmaceutical first-line group (treatment with somatostatin analogues [SAs] for at least 6 months and with or without surgery after starting treatment with SAs). Data were collected during routine visits made during a follow-up period of 2 years. All resources were estimated at 2009 prices (€) and adjusted according to the Spanish consumer price index in 2010.
Seventy-four patients were included, the majority of them with macroadenoma (70%). Eighty-eight percent of patients were treated surgically (76% as a first-line treatment), while 12% of patients received only SAs. Treatment with SAs was used at some point in the study by 85% of patients. The mean annual total cost of acromegaly is €9668 per patient (€9223 for the surgery group and €11,054 for the pharmaceutical group). Seventy-one percent of the direct cost of the disease corresponds to treatment with SAs. The cost of a patient treated only with surgery is €2501 on an annual basis, versus €9745 for a patient receiving only pharmacological treatment. In cases where a combination of both types of treatment is required, the annual total cost ranges from €10,866 to €12,364.
The annual direct cost per patients of acromegaly in Spain is €9668. Even though surgery is the preferred option for treatment for a great number of patients, SAs must be added to the treatment regimen of the majority of such patients. The costs associated with this treatment are greater than the cost of treatment with SAs alone.
肢端肥大症的治疗管理费用取决于治疗专家所选择的资源，包括手术和/或药物治疗，这与患者和肿瘤的特征有关。本项工作的目的是评估在常规临床实践中，这种罕见但发病率较高的疾病的相关成本。
这是在西班牙进行的一项流行病学、前瞻性、自然主义、多中心研究，共有 38 名内分泌学家参与。研究纳入了患有垂体微腺瘤或大腺瘤的肢端肥大症成年患者。根据一线治疗，将患者分为以下两组：手术一线组（入组前 6 个月或随访期间进行手术）和药物一线组（至少接受 6 个月生长抑素类似物[SA]治疗，且在开始 SA 治疗后进行手术或不手术）。在 2 年的随访期间，在常规就诊时收集数据。所有资源均按 2009 年价格（€）进行估算，并根据 2010 年西班牙消费者价格指数进行调整。
共纳入 74 例患者，其中大多数为大腺瘤（70%）。88%的患者接受了手术治疗（76%作为一线治疗），而 12%的患者仅接受 SA 治疗。研究期间，85%的患者曾接受过 SA 治疗。肢端肥大症患者的年平均总费用为每位患者 9668 欧元（手术组为 9223 欧元，药物组为 11054 欧元）。71%的疾病直接成本与 SA 治疗相关。仅接受手术治疗的患者的年费用为 2501 欧元，而仅接受药物治疗的患者的年费用为 9745 欧元。在需要联合应用两种治疗方法的情况下，年总费用范围为 10866 欧元至 12364 欧元。
西班牙肢端肥大症患者的年直接医疗费用为 9668 欧元。尽管手术是大多数患者的首选治疗方法，但大多数此类患者的治疗方案中还需添加 SA。这种治疗相关的成本高于单独使用 SA 的成本。
