Department of Clinical Neuroscience, King's College London, London, UK.
Eur J Neurol. 2014;21(1):34-9. doi: 10.1111/ene.12245. Epub 2013 Aug 9.
Cost-of-illness studies and health-related quality of life (HRQoL) measurements are needed to assess the effects of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multifocal motor neuropathy (MMN) and paraproteinaemic demyelinating neuropathy (PDN) on society.
This study was conducted in 2008 in a southeast England population of 3,557,352 people. Data on service use and treatment were collected with a client service receipt inventory and service costs were calculated by combining these data with national unit costs. The EuroQol was used to calculate utility scores, a measurement of HRQoL.
The total annual cost-of-illness per patient was £22,085 for CIDP, £22,812 for MMN and £7566 for PDN. The annual total cost per patient was £49,430 for individuals on intravenous immunoglobulin (IVIg) and £9046 for those not on IVIg (P < 0.01). The mean (SD) utility scores were 0.62 (0.23) for CIDP, 0.63 (0.22) for PDN and 0.72 (0.14) for MMN (P = 0.52). The mean (SD) utility score for those on IVIg was 0.65 (0.16) and those not on IVIg 0.63 (0.23) (P = 0.77).
The use of IVIg was the most important determinant of cost in all three diseases and the higher frequency of its use in CIDP and MMN accounted for the much greater average cost per patient in these diseases. There was no significant difference in HRQoL amongst the three diseases or between those receiving or not receiving IVIg.
需要进行疾病经济负担研究和健康相关生活质量(HRQoL)测量,以评估慢性炎症性脱髓鞘性多发性神经病(CIDP)、多发性运动神经病(MMN)和副蛋白血症性脱髓鞘神经病(PDN)对社会的影响。
本研究于 2008 年在英格兰东南部一个 3557352 人的人群中进行。使用客户服务收据清单收集服务使用和治疗数据,并结合这些数据和国家单位成本计算服务成本。使用 EuroQol 计算效用评分,这是 HRQoL 的一种衡量标准。
CIDP、MMN 和 PDN 患者的年总疾病经济负担分别为 22085 英镑、22812 英镑和 7566 英镑。接受静脉注射免疫球蛋白(IVIg)治疗的患者年总费用为 49430 英镑,未接受 IVIg 治疗的患者为 9046 英镑(P<0.01)。CIDP、PDN 和 MMN 的平均(SD)效用评分分别为 0.62(0.23)、0.63(0.22)和 0.72(0.14)(P=0.52)。接受 IVIg 治疗的患者的平均(SD)效用评分为 0.65(0.16),未接受 IVIg 治疗的患者为 0.63(0.23)(P=0.77)。
IVIg 的使用是所有三种疾病中最重要的成本决定因素,CIDP 和 MMN 中 IVIg 的使用频率更高,导致这些疾病的平均每位患者成本更高。三种疾病之间或接受和不接受 IVIg 治疗的患者之间的 HRQoL 没有显著差异。