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德国多发性硬化症患者在服用氨吡啶治疗前及治疗期间的医疗资源使用情况和费用

Healthcare resource use and costs of multiple sclerosis patients in Germany before and during fampridine treatment.

作者信息

Ziemssen Tjalf, Prosser Christine, Haas Jennifer Scarlet, Lee Andrew, Braun Sebastian, Landsman-Blumberg Pamela, Kempel Angela, Gleißner Erika, Patel Sarita, Huang Ming-Yi

机构信息

Universitätsklinium Dresden, Fetscherstraße 74, 01307, Dresden, Germany.

Xcenda GmbH, Lange Laube 31, D-30159, Hannover, Germany.

出版信息

BMC Neurol. 2017 Mar 27;17(1):62. doi: 10.1186/s12883-017-0844-z.

Abstract

BACKGROUND

Multiple sclerosis (MS) patients often suffer from gait impairment and fampridine is indicated to medically improve walking ability in this population. Patient characteristics, healthcare resource use, and costs of MS patients on fampridine treatment for 12 months in Germany were analyzed.

METHODS

A retrospective claims database analysis was conducted including MS patients who initiated fampridine treatment (index date) between July 2011 and December 2013. Continuous insurance enrollment during 12 months pre- and post-index date was required, as was at least 1 additional fampridine prescription in the fourth quarter after the index date. Patient characteristics were evaluated and pre- vs post-index MS-related healthcare utilization and costs were compared.

RESULTS

A total of 562 patients were included in this study. The mean (standard deviation [SD]) age was 50.5 (9.8) years and 63% were female. In the treatment period, almost every patient had at least 1 MS-related outpatient visit, 24% were hospitalized due to MS, and 79% utilized MS-specific physical therapy in addition to the fampridine treatment. Total MS-related healthcare costs were significantly higher in the fampridine treatment period than in the period prior to fampridine initiation (€17,392 vs €10,960, P < 0.001). While this difference was driven primarily by prescription costs, MS-related inpatient costs were lower during fampridine treatment (€1,333 vs €1,565, P < 0.001).

CONCLUSIONS

Physical therapy is mainly used concomitant to fampridine treatment. While healthcare costs were higher during fampridine treatment compared to the pre-treatment period, inpatient costs were lower. Further research is necessary to better understand the fampridine influence.

摘要

背景

多发性硬化症(MS)患者常伴有步态障碍,而氨吡啶被用于医学上改善该人群的行走能力。分析了德国接受氨吡啶治疗12个月的MS患者的特征、医疗资源使用情况及费用。

方法

进行一项回顾性索赔数据库分析,纳入2011年7月至2013年12月开始氨吡啶治疗(索引日期)的MS患者。要求在索引日期前后12个月持续参保,且在索引日期后的第四季度至少有1次额外的氨吡啶处方。评估患者特征,并比较索引日期前后与MS相关的医疗利用情况及费用。

结果

本研究共纳入562例患者。平均(标准差[SD])年龄为50.5(9.8)岁,63%为女性。在治疗期间,几乎每位患者至少有1次与MS相关的门诊就诊,24%因MS住院,79%在氨吡啶治疗之外还接受了MS特异性物理治疗。与MS相关的总医疗费用在氨吡啶治疗期间显著高于开始氨吡啶治疗之前(17392欧元对10960欧元,P<0.001)。虽然这种差异主要由处方费用驱动,但与MS相关的住院费用在氨吡啶治疗期间较低(1333欧元对1565欧元,P<0.001)。

结论

物理治疗主要与氨吡啶治疗同时使用。虽然与治疗前相比,氨吡啶治疗期间的医疗费用较高,但住院费用较低。有必要进行进一步研究以更好地了解氨吡啶的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db5f/5369011/1f07f37ec611/12883_2017_844_Fig1_HTML.jpg

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