Dilokthornsakul Piyameth, Valuck Robert J, Nair Kavita V, Corboy John R, Allen Richard R, Campbell Jonathan D
From the Center for Pharmaceutical Outcomes Research (P.D., R.J.V., K.V.N., J.D.C.), University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora; Center of Pharmaceutical Outcomes Research (P.D.), Faculty of Pharmaceutical Sciences, Naresuan University, Muang, Phitsanulok, Thailand; Department of Neurology (J.R.C.), University of Colorado School of Medicine, Aurora; and Peak Statistical Services (R.R.A.), Evergreen, CO.
Neurology. 2016 Mar 15;86(11):1014-21. doi: 10.1212/WNL.0000000000002469. Epub 2016 Feb 17.
To estimate the US commercially insured multiple sclerosis (MS) annual prevalence from 2008 to 2012.
The study was a retrospective analysis using PharMetrics Plus, a nationwide claims database for over 42 million covered US representative lives. Annual point prevalence required insurance eligibility during an entire year. Our primary annual MS identification algorithm required 2 inpatient claims coded ICD-9 340 or 3 outpatient claims coded ICD-9 340 or 1 MS-indicated disease-modifying therapy claim. Age-adjusted annual prevalence estimates were extrapolated to the US population using US Census data.
The 2012 MS prevalence was 149.2 per 100,000 individuals (95% confidence interval 147.6-150.9). Prevalence was consistent over 2008-2012. Female participants were 3.13 times more likely to have MS. The highest prevalence was in participants aged 45-49 years (303.5 per 100,000 individuals [295.6-311.5]). The East Census region recorded the highest prevalence (192.1 [188.2-196.0]); the West Census region recorded the lowest prevalence (110.7 [105.5-116.0]). The US annual 2012 MS extrapolated population was 403,630 (387,445-419,833).
MS prevalence rates from a representative commercially insured database were higher than or consistent with prior US estimates. For further accuracy improvement of US prevalence estimates, results should be confirmed after validation of MS identification algorithms, and should be expanded to other US populations, including the government-insured and the uninsured.
评估2008年至2012年美国商业保险覆盖人群中多发性硬化症(MS)的年度患病率。
本研究采用PharMetrics Plus进行回顾性分析,该数据库是一个覆盖全美4200多万参保人员的全国性理赔数据库。年度时点患病率要求全年具备保险资格。我们主要的年度MS识别算法要求有2份编码为ICD-9 340的住院理赔记录,或3份编码为ICD-9 340的门诊理赔记录,或1份有MS指征的疾病修饰治疗理赔记录。使用美国人口普查数据将年龄调整后的年度患病率估计值外推至美国总体人群。
2012年MS患病率为每10万人中149.2例(95%置信区间147.6 - 150.9)。患病率在2008 - 2012年期间保持稳定。女性参与者患MS的可能性是男性的3.13倍。患病率最高的是45 - 49岁的参与者(每10万人中303.5例[295.6 - 311.5])。美国人口普查东部地区患病率最高(192.1[188.2 - 196.0]);西部地区患病率最低(110.7[105.5 - 116.0])。2012年美国MS外推患病人数为403,630例(387,445 - 419,833)。
来自具有代表性商业保险数据库的MS患病率高于或与美国先前的估计一致。为进一步提高美国患病率估计的准确性,应在验证MS识别算法后确认结果,并应扩大到美国其他人群,包括政府保险覆盖人群和未参保人群。