Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, 1093, Budapest, Hungary.
Eur J Health Econ. 2014 May;15 Suppl 1:S101-9. doi: 10.1007/s10198-014-0599-z. Epub 2014 May 16.
Despite the widespread availability of biological drugs in psoriasis, there is a shortage of disease burden studies.
To assess the cost-of-illness and quality of life of patients with moderate to severe psoriasis in Hungary.
Consecutive patients with Psoriasis Area and Severity Index (PASI) > 10 and Dermatology Life Quality Index (DLQI) > 10, or treated with traditional systemic (TST) or biological systemic treatment (BST) were included. Demographic data, clinical characteristics, psoriasis related medication, health care utilizations and employment status in the previous 12 months were recorded. Costing was performed from the societal perspective applying the human capital approach. Quality of life was assessed using DLQI and EQ-5D measures.
Two-hundred patients were involved (females 32%) with a mean age of 51 (SD 13) years, 103 (52%) patients were on BST. Mean PASI, DLQI and EQ-5D scores were 8 (SD 10), 6 (SD 7) and 0.69 (SD 0.3), respectively. The mean total cost was €9,254/patient/year (SD 8,502) with direct costs accounting for 86%. The main cost driver was BST (mean €7,339/patient/year). Total costs differed significantly across treatment subgroups, mean (SD): no systemic therapy €2,186 (4,165), TST €2,388 (4,106) and BST €15,790 (6,016) (p < 0,001). Patients with BST had better PASI and DLQI scores (p < 0.01) than the other two subgroups.
Patients with biological treatment have a significantly better quality of life and higher total costs than patients with or without traditional systemic treatment. Our study is the largest in Europe and the first in the CEE region that provides cost-of-illness data in psoriasis involving patients with BST.
尽管在银屑病的治疗中广泛使用了生物药物，但仍缺乏疾病负担的研究。
评估匈牙利中重度银屑病患者的疾病经济负担和生活质量。
纳入银屑病面积和严重程度指数（PASI）>10 且皮肤病生活质量指数（DLQI）>10 的患者，或接受传统系统性治疗（TST）或生物系统性治疗（BST）的患者。记录人口统计学数据、临床特征、与银屑病相关的药物治疗、过去 12 个月的医疗保健利用情况和就业状况。从社会角度应用人力资本方法进行成本核算。采用 DLQI 和 EQ-5D 评估生活质量。
共纳入 200 例患者（女性占 32%），平均年龄为 51（SD 13）岁，103 例（52%）患者接受 BST。平均 PASI、DLQI 和 EQ-5D 评分为 8（SD 10）、6（SD 7）和 0.69（SD 0.3）。每位患者每年的平均总费用为 9254 欧元（SD 8502），直接成本占 86%。主要成本驱动因素是 BST（平均每位患者每年 7339 欧元）。各治疗亚组的总费用差异显著，平均值（SD）分别为：无系统性治疗 2186 欧元（4165）、TST 2388 欧元（4106）和 BST 15790 欧元（6016）（p<0.001）。与其他两个亚组相比，接受 BST 的患者 PASI 和 DLQI 评分更好（p<0.01）。
与接受传统系统性治疗或未接受系统性治疗的患者相比，接受生物治疗的患者生活质量更好，总费用更高。本研究是欧洲规模最大、也是中欧和东欧地区首个提供生物治疗患者疾病经济负担数据的研究。
