Li Jinghu, Liu Qingjing, Chen Yi, Gao Shuangqing, Zhang Jie, Yang Yicheng, Chen Wendong
a China Health Insurance Research Association , Beijing , PR China.
b Beijing North Medical & Health Economics Research Center , Beijing , PR China.
J Med Econ. 2017 Jan;20(1):91-97. doi: 10.1080/13696998.2016.1227829. Epub 2016 Sep 7.
To describe treatment pattern, complications, and direct medical costs associated with ankylosing spondylitis (AS) in Chinese urban patients.
The 2013 China Health Insurance Research Association (CHIRA) urban insurance claims database was used to identify patients with AS. The identified patients were stratified by AS treatments for the comparisons of well established AS-related complications and direct medical costs. Conventional regression analyses adjusted the collected patient baseline characteristics to confirm the impact of treatments on complications and direct medical costs.
Of the identified 1299 patients with AS, 18.0% received non-steroidal anti-inflammatory drugs (NSAID), 11.2% received immunosuppressant, 48.2% received NSAID plus immunosuppressant, 4.6% received biologic agents, and 17.9% received medications without indication for AS. Biologic group was associated with the lowest proportion of AS-related complications (8.3%) that was confirmed by multiple logistic regression analysis (odds ratio = 0.200, p = .017). The biologic group was also associated with highest direct medical costs (median: RMB = 14,539) that were confirmed by the multiple generalized linear model (coefficient = 1.644, p < .001).
Biologics were not commonly used for AS in Chinese patients likely due to their high cost. Future studies are needed to confirm the potential long-term clinical benefits associated biologic treatment for AS.
描述中国城市强直性脊柱炎(AS)患者的治疗模式、并发症及直接医疗费用。
利用2013年中国健康保险研究会(CHIRA)城市保险理赔数据库识别AS患者。将识别出的患者按AS治疗方法分层,以比较既定的AS相关并发症和直接医疗费用。采用常规回归分析对收集的患者基线特征进行调整,以确认治疗对并发症和直接医疗费用的影响。
在识别出的1299例AS患者中,18.0%接受非甾体抗炎药(NSAID)治疗,11.2%接受免疫抑制剂治疗,48.2%接受NSAID加免疫抑制剂治疗,4.6%接受生物制剂治疗,17.9%接受无AS适应症的药物治疗。生物制剂组AS相关并发症的比例最低(8.3%),经多因素logistic回归分析证实(比值比=0.200,p = 0.017)。生物制剂组的直接医疗费用也最高(中位数:人民币=14539元),经多因素广义线性模型证实(系数=1.644,p < 0.001)。
生物制剂在中国AS患者中使用不普遍,可能是因为费用高昂。需要进一步研究以证实生物制剂治疗AS的潜在长期临床益处。