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美国巨细胞动脉炎疾病成本的估算

Estimating the Cost of Illness of Giant Cell Arteritis in the United States.

作者信息

Babigumira Joseph B, Li Meng, Boudreau Denise M, Best Jennie H, Garrison Louis P

机构信息

Global Medicines Program, Department of Global Health, University of Washington, Seattle, WA, USA.

Pharmaceutical Outcomes Research and Policy Program, Department of Pharmacy, University of Washington, Seattle, WA, USA.

出版信息

Rheumatol Ther. 2017 Jun;4(1):111-119. doi: 10.1007/s40744-017-0052-8. Epub 2017 Jan 13.

Abstract

INTRODUCTION

Giant cell arteritis (GCA) is a chronic vasculitis affecting approximately 230,000 Americans. Limited data exist on the healthcare resource utilization and costs attributable to GCA. The objective of this study was to estimate the cost of illness in patients with GCA in the US.

METHODS

A cohort of patients with a new GCA diagnosis was identified from a large US claims database between 1 January 2008 and 31 December 2012. Newly diagnosed GCA patients were defined by two claims with GCA (ICD-9 446.5) as one of the listed diagnoses during the study period and no GCA diagnosis in the 12 months prior. Subjects without a GCA diagnosis were matched 5:1 to cases. One-year healthcare costs were compared among cases and controls, adjusting for covariates using generalized linear models.

RESULTS

A cohort of 1293 GCA patients and 6465 controls was identified. The mean age was 73 years, and 69% were females. Mean Charlson Comorbidity Index was 1.9 for GCA patients and 1.0 for controls. Mean 1-year cost for GCA patients was $34,065 [standard deviation (SD) $52,411], and mean 1-year cost for controls was $12,890 (SD $37,345). After multivariate adjustment, the difference in 1-year cost between GCA patients and controls was $16,431 (95% CI $13,821-$19,041).

CONCLUSIONS

Patients with GCA experience substantially higher healthcare costs in the first year following diagnosis compared to patients without GCA. These results add to the limited evidence available to inform researchers, clinicians, and policymakers on the cost burden of GCA in the US.

FUNDING

Genentech Inc.

摘要

引言

巨细胞动脉炎(GCA)是一种慢性血管炎,影响着约23万美国人。关于GCA的医疗资源利用情况和相关成本的数据有限。本研究的目的是估计美国GCA患者的疾病成本。

方法

从一个大型美国索赔数据库中识别出2008年1月1日至2012年12月31日期间新诊断为GCA的患者队列。新诊断的GCA患者定义为在研究期间有两条索赔记录,其中GCA(国际疾病分类第九版代码446.5)为列出的诊断之一,且在之前12个月内无GCA诊断。未诊断为GCA的受试者与病例按5:1进行匹配。使用广义线性模型对协变量进行调整后,比较病例组和对照组的一年医疗成本。

结果

识别出1293例GCA患者和6465例对照组。平均年龄为73岁,69%为女性。GCA患者的平均查尔森合并症指数为1.9,对照组为1.0。GCA患者的平均一年成本为34,065美元[标准差(SD)52,411美元],对照组的平均一年成本为12,890美元(SD 37,345美元)。多变量调整后,GCA患者和对照组的一年成本差异为16,431美元(95%置信区间13,821 - 19,041美元)。

结论

与未患GCA的患者相比,GCA患者在诊断后的第一年医疗成本要高得多。这些结果为研究人员、临床医生和政策制定者了解美国GCA的成本负担提供了有限的证据。

资助

基因泰克公司

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