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2000 年至 2013 年欧洲和美国克罗恩病的经济和生活质量负担:系统评价。

The economic and quality-of-life burden of Crohn's disease in Europe and the United States, 2000 to 2013: a systematic review.

机构信息

PHMR Associates, London, UK.

出版信息

Dig Dis Sci. 2015 Feb;60(2):299-312. doi: 10.1007/s10620-014-3368-z. Epub 2014 Sep 26.

Abstract

BACKGROUND

Crohn's disease (CD) is associated with a substantial healthcare burden that affects the patient, healthcare systems and society in general.

AIM

To provide a systematic evaluation of published data relating to the economic and health-related quality-of-life (HRQoL) burden of CD in selected European countries (Germany, France, UK, Italy, Spain) and the USA since 2000.

METHODS

We undertook a systematic review of publications relating to CD, its economic burden and impact on HRQoL. Research questions focused on the disease costs from a societal perspective and HRQoL burden in adults and pediatric/adolescent patients according to disease stage/severity. Total, direct and indirect costs were identified, as well as the impact of CD on HRQoL measured using both generic and disease-specific instruments.

RESULTS

Overall, 61 publications met the research criteria (38 on costs, 23 on HRQoL). CD in the USA and Europe together was associated with annual total costs of nearly 30 billion, more than half due to indirect costs. HRQoL was consistently and statistically significantly lower among CD patients compared with normal populations, due to physical, emotional and social effects.

CONCLUSIONS

CD is a global health problem with high societal costs and substantial HRQoL burden. High-value care pathways including cost-effective therapies will help to induce and maintain remission, reduce complications of disease and improve HRQoL.

摘要

背景

克罗恩病(CD)与大量医疗负担相关,影响患者、医疗系统和整个社会。

目的

系统评估 2000 年以来选定欧洲国家(德国、法国、英国、意大利、西班牙)和美国发表的有关 CD 的经济和健康相关生活质量(HRQoL)负担的文献。

方法

我们对有关 CD、经济负担及其对 HRQoL 影响的文献进行了系统评价。研究问题集中在从社会角度考虑疾病的成本和根据疾病阶段/严重程度对成人和儿科/青少年患者的 HRQoL 负担。确定了总费用、直接费用和间接费用,以及使用通用和疾病特异性工具衡量 CD 对 HRQoL 的影响。

结果

总体而言,有 61 篇文献符合研究标准(38 篇关于成本,23 篇关于 HRQoL)。美国和欧洲的 CD 每年总费用接近 300 亿欧元,超过一半是间接费用。由于身体、情感和社会影响,CD 患者的 HRQoL 始终显著低于正常人群。

结论

CD 是一个全球性的健康问题,具有高社会成本和大量的 HRQoL 负担。包括具有成本效益的治疗方法在内的高价值护理途径将有助于诱导和维持缓解,减少疾病并发症并改善 HRQoL。

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