Montgomery William, Sato Masayo, Nagasaka Yasuo, Vietri Jeffrey
Global Patient Outcomes & Real World Evidence, Eli Lilly Australia Pty Ltd., West Ryde, Australia.
Medical Development Unit Japan, Eli Lilly Japan K.K., Kobe, Japan.
Clinicoecon Outcomes Res. 2017 Jun 23;9:361-371. doi: 10.2147/CEOR.S134130. eCollection 2017.
Few data are available that provide estimates of the economic impact of chronic lower back pain (CLBP) in Japan. The current study estimated the patient burden and the direct and indirect medical costs associated with CLBP in Japan using data from a large cross-sectional patient survey. CLBP was hypothesized to be associated with a considerable burden of illness and a large economic impact.
Study participants completed the Japan National Health and Wellness Survey in 2014, which included measures of health-related quality of life (HRQoL), work impairment, impairment to daily activities, and healthcare service use. Data from those reporting CLBP (N=392) were contrasted against those from matched controls without back pain, using age and sex-adjusted models.
CLBP patients reported significantly lower HRQoL relative to matched controls. Age-and sex-adjusted models estimated mean annual per patient direct and indirect costs attributable to CLBP to be ¥1,820,297 ($15,239 or €12,551) and ¥1,479,899 ($12,389 or €10,203), respectively, with the majority of direct costs related to hospital expenses (¥1,584,759, which is equivalent to $13,267 and €10,927). In estimating the economic impact of CLBP on society, the CLBP respondents were estimated to include 1,508,524 individuals when extrapolated to the Japanese population (815,461 of them employed). Ultimately, this represented approximately ¥1.2 trillion ($10 billion and €8.3 billion) per year in lost productivity at the time of this study.
This study of patients with CLBP in Japan has shown it to be associated with a significant burden on patients and to have a considerable negative impact on the Japanese economy primarily driven by lost productivity. Further research on the effectiveness of interventions to improve the outcomes of those with CLBP is warranted.
关于日本慢性下腰痛(CLBP)经济影响的评估数据较少。本研究利用一项大型横断面患者调查的数据,估算了日本CLBP患者的负担以及与之相关的直接和间接医疗费用。据推测,CLBP与相当大的疾病负担和巨大的经济影响相关。
研究参与者于2014年完成了日本国民健康与生活方式调查,该调查包括与健康相关的生活质量(HRQoL)、工作能力受损、日常活动能力受损以及医疗服务使用情况的测量。报告有CLBP的患者(N = 392)的数据与年龄和性别匹配的无背痛对照者的数据进行对比,采用年龄和性别调整模型。
与匹配的对照者相比,CLBP患者报告的HRQoL显著更低。年龄和性别调整模型估计,CLBP患者每年人均直接和间接费用分别为1,820,297日元(15,239美元或12,551欧元)和1,479,899日元(12,389美元或10,203欧元),其中大部分直接费用与住院费用相关(1,584,759日元,相当于13,267美元和10,927欧元)。在估算CLBP对社会的经济影响时,将CLBP受访者的数据外推至日本人口时,估计有1,508,524人(其中815,461人就业)。在本研究开展之时,这最终相当于每年约1.2万亿日元(100亿美元和83亿欧元)的生产力损失。
这项针对日本CLBP患者的研究表明,它给患者带来了重大负担,并对日本经济产生了相当大的负面影响,主要原因是生产力损失。有必要进一步研究改善CLBP患者治疗效果的干预措施的有效性。