Campbell Jonathan D, Ghushchyan Vahram, Brett McQueen R, Cahoon-Metzger Sharon, Livingston Terrie, Vollmer Timothy, Corboy John, Miravalle Augusto, Schreiner Teri, Porter Victoria, Nair Kavita
University of Colorado, Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.
Biogen Idec, Medical and Outcomes Science, Weston, MA, USA.
Mult Scler Relat Disord. 2014 Mar;3(2):227-36. doi: 10.1016/j.msard.2013.09.004. Epub 2013 Nov 2.
MS imposes a significant burden on patients, caregivers, employers, and the healthcare system.
To comprehensively evaluate the US MS burden using nationally representative data from the Medical Expenditure Panel Survey.
We identified non-institutionalized patients aged ≥18 with MS (ICD-9 code 340) from 1998 to 2009 and compared them to individuals without an MS diagnosis (non-MS) during the interview year. The cohorts were compared using multivariate regression on direct costs, indirect costs (measured in terms of employment status, annual wages, and workdays missed), and health-related quality of life (HRQoL; measured using Short Form 12, SF-6 Dimensions, and quality-adjusted life years [QALYs]).
MS prevalence was 572,312 (95% CI: 397,004, 747,619). Annual direct costs were $24,327 higher for the MS population (n=526) vs. the non-MS population (n=270,345) (95% CI: $22,320, $26,333). MS patients had an adjusted 3.3-fold (95% CI: 2.4, 4.5) increase in the odds of not being employed vs. non-MS individuals and a 4.4-fold higher adjusted number of days in bed (95% CI 2.97, 6.45). On average, MS patients lost 10.04 QALYs vs. non-MS cohort.
MS was associated with higher healthcare costs across all components, reduced productivity due to unemployment and days spent in bed, and lower HRQoL.
多发性硬化症给患者、护理人员、雇主和医疗保健系统带来了沉重负担。
利用医疗支出小组调查中具有全国代表性的数据，全面评估美国多发性硬化症的负担。
我们从1998年至2009年中确定了年龄≥18岁的非住院多发性硬化症患者（国际疾病分类第九版代码340），并将他们与在访谈年份未被诊断为多发性硬化症的个体（非多发性硬化症患者）进行比较。使用多变量回归对直接成本、间接成本（根据就业状况、年薪和缺勤天数衡量）以及健康相关生活质量（HRQoL；使用简短健康调查问卷12项、SF-6维度和质量调整生命年[QALY]衡量）对这两组人群进行比较。
多发性硬化症患病率为572,312（95%置信区间：397,004, 747,619）。多发性硬化症患者群体（n = 526）的年度直接成本比非多发性硬化症患者群体（n = 270,345）高24,327美元（95%置信区间：22,320美元，26,333美元）。与非多发性硬化症患者相比，多发性硬化症患者未就业的几率调整后增加了3.3倍（95%置信区间：2.4, 4.5），卧床天数调整后增加了4.4倍（95%置信区间2.97, 6.45）。平均而言，多发性硬化症患者与非多发性硬化症患者群体相比损失了10.04个质量调整生命年。
多发性硬化症与所有组成部分的更高医疗成本、因失业和卧床天数导致的生产力下降以及更低的健康相关生活质量相关。
