Dal Negro Roberto W, Distante Chiara, Bonadiman Luca, Turco Paola, Iannazzo Sergio
National Centre for Respiratory Pharmacoeconomics and Pharmacoepidemiology, Verona, Italy.
SIHS Health Economics Consulting, Torino, Italy.
Multidiscip Respir Med. 2016 Dec 16;11:44. doi: 10.1186/s40248-016-0080-1. eCollection 2016.
Asthma is a common disease of the airways with a significant burden for the society and for patients' quality of life. The Social Impact of Respiratory Integrated Outcomes (SIRIO) study estimated a mean cost of 1,177.40 € per patient/year in Italy, in 2007. The aim of the present study was to update the cost of persistent asthma patients in Italy.
An observational, retrospective, bottom-up analysis was carried out starting from the data base operating in the Lung Unit of the Specialist Medical Centre (CEMS), Verona (Italy), over the period June 2013-December 2015. Patients' data were recorded over the 12 ± 2 months before the enrollment and during 12 ± 2 months of follow-up. The prospective was the Italian National Health Service and the broad Italian society. Clinical data were measured in terms of forced expiratory volume in 1 s (FEV%) and number of relapses. Healthcare resources (namely; number of hospitalizations and/or ER admissions; number of visits; drug use and duration, and indirect costs) were recorded.
The cohort consisted of 817 patients with persistent asthma of different severity. They had a 42.96% male prevalence; a mean (±SE) age of 49.06 (±0.64) years; a mean 87.47% (±0.81) FEV% pred. in baseline, and 69.16% of subjects had comorbidities. The mean (±SE) number of relapses was 0.91 (±0.09) per patient/year before the enrolment. After 12 months, FEV% significantly improved by +6.31% (±0.45) from the corresponding baseline value ( < 0.001). The number of relapses decreased of -0.46 (±0.09) ( < 0.001). The estimated total annual cost per asthmatic patient was 1,183.14 € (±65.79 €) during the 12 months before the enrolment, and 1,290.89 € (±68.74 €) throughout the follow-up. The increase was mostly due to the significantly increased duration of therapeutic strategies. The costs of hospitalization, general practitioner and rescue medications were significantly decreased.
The periodic update of cost analysis is a key to monitor the trend of main asthma outcomes and related expenditure over time. It allows to plan the most convenient actions in terms of prevention strategies and effective interventions, with the aim of optimizing the healthcare resources consumption and maximizing the impact on clinical outcomes and patients' quality of life. The role of an appropriate pharmacological strategy still proves crucial in minimizing asthma morbidity and the corresponding socio-economic impact.
哮喘是一种常见的气道疾病，给社会和患者生活质量带来了沉重负担。呼吸综合结局的社会影响（SIRIO）研究估计，2007年意大利每位患者每年的平均费用为1177.40欧元。本研究的目的是更新意大利持续性哮喘患者的费用情况。
从意大利维罗纳专科医疗中心（CEMS）肺病科2013年6月至2015年12月运行的数据库开始，进行了一项观察性、回顾性、自下而上的分析。在入组前12±2个月和随访的12±2个月期间记录患者数据。研究对象为意大利国家医疗服务体系和广大意大利社会。临床数据通过1秒用力呼气量（FEV%）和复发次数来衡量。记录医疗资源（即住院和/或急诊入院次数、就诊次数、药物使用及持续时间以及间接成本）。
该队列由817例不同严重程度的持续性哮喘患者组成。男性患病率为42.96%；平均（±标准误）年龄为49.06（±0.64）岁；基线时平均FEV%预计值为87.47%（±0.81），69.16%的受试者有合并症。入组前每位患者每年的平均（±标准误）复发次数为0.91（±0.09）次。12个月后，FEV%较相应基线值显著提高了+6.31%（±0.45）（P<0.001）。复发次数减少了-0.46（±0.09）次（P<0.001）。入组前12个月每位哮喘患者的估计年度总费用为1183.14欧元（±65.79欧元），随访期间为1290.89欧元（±68.74欧元）。费用增加主要是由于治疗策略的持续时间显著增加。住院、全科医生和急救药物的费用显著降低。
定期更新成本分析是监测主要哮喘结局和相关支出随时间变化趋势的关键。它有助于规划预防策略和有效干预方面最便捷的行动，以优化医疗资源消耗并最大化对临床结局和患者生活质量的影响。适当的药物治疗策略在最小化哮喘发病率和相应的社会经济影响方面仍然至关重要。
