Eriksson Daniel, Karlsson Linda, Eklund Oskar, Dieperink Hans, Honkanen Eero, Melin Jan, Selvig Kristian, Lundberg Johan
Quantify Research, Hantverkargatan 8, 112 21, Stockholm, Sweden.
Odense University Hospital, Department of Nephrology, Sdr. Boulevard 29, DK-5000, Odense C, Denmark.
BMC Health Serv Res. 2017 Aug 15;17(1):560. doi: 10.1186/s12913-017-2513-8.
There is limited real-world data on the economic burden of patients with autosomal dominant polycystic kidney disease (ADPKD). The objective of this study was to estimate the annual direct and indirect costs of patients with ADPKD by severity of the disease: chronic kidney disease (CKD) stages 1-3; CKD stages 4-5; transplant recipients; and maintenance dialysis patients.
A retrospective study of ADPKD patients was undertaken April-December 2014 in Denmark, Finland, Norway and Sweden. Data on medical resource utilisation were extracted from medical charts and patients were asked to complete a self-administered questionnaire.
A total of 266 patients were contacted, 243 (91%) of whom provided consent to participate in the study. Results showed that the economic burden of ADPKD was substantial at all levels of the disease. Lost wages due to reduced productivity were large in absolute terms across all disease strata. Mean total annual costs were highest in dialysis patients, driven by maintenance dialysis care, while the use of immunosuppressants was the main cost component for transplant care. Costs were twice as high in patients with CKD stages 4-5 compared to CKD stages 1-3.
Costs associated with ADPKD are significant and the progression of the disease is associated with an increased frequency and intensity of medical resource utilisation. Interventions that can slow the progression of the disease have the potential to lead to substantial reductions in costs for the treatment of ADPKD.
关于常染色体显性多囊肾病(ADPKD)患者经济负担的真实世界数据有限。本研究的目的是根据疾病严重程度估计ADPKD患者的年度直接和间接成本:慢性肾脏病(CKD)1 - 3期;CKD 4 - 5期;移植受者;以及维持性透析患者。
2014年4月至12月在丹麦、芬兰、挪威和瑞典对ADPKD患者进行了一项回顾性研究。从病历中提取医疗资源利用数据,并要求患者完成一份自填式问卷。
共联系了266名患者,其中243名(91%)同意参与研究。结果表明,ADPKD在疾病的各个阶段经济负担都很大。在所有疾病分层中,因生产力下降导致的工资损失绝对值都很大。透析患者的年平均总成本最高,主要是由于维持性透析治疗,而免疫抑制剂的使用是移植治疗的主要成本组成部分。CKD 4 - 5期患者的成本是CKD 1 - 3期患者的两倍。
与ADPKD相关的成本很高,疾病进展与医疗资源利用的频率和强度增加有关。能够减缓疾病进展的干预措施有可能大幅降低ADPKD的治疗成本。