Kong Amanda M, Kim Gilwan, Michalska Margaret, Best Jennie H
Truven Health Analytics, an IBM Company, Cambridge, MA, USA.
Genentech, Inc, South San Francisco, CA, USA.
Rheumatol Ther. 2018 Jun;5(1):159-170. doi: 10.1007/s40744-018-0099-1. Epub 2018 Feb 22.
Granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) are two related forms of systemic vasculitis. Patients with these conditions often experience relapses affecting various body systems. Here we describe rates of relapse and review healthcare costs resulting from relapse among patients with GPA/MPA.
Two groups of patients with GPA and MPA were selected from the MarketScan claims databases between 2011 and 2013 based on diagnosis codes. Patients were followed for 12 months to identify relapses based on an algorithm of diagnoses in medical and medication claims. Relapses were categorized into one of the following groups: renal relapse, pulmonary relapse, other relapse-associated condition relapse, GPA or MPA utilization relapse, and mixed relapse.
The final sample of patients with GPA and MPA consisted of 2707 and 740 patients, respectively. In both groups, approximately one-quarter of patients experienced relapse during the 12-month follow-up period. The mean all-cause healthcare costs in the 4-month period after relapse were $38,313 (SD, $54,120) for patients with GPA and $35,947 (SD, $48,065) for patients with MPA. In both groups, renal relapses were the costliest. Costs during the 4 months immediately following relapses were substantially higher than what could be expected over a 4-month follow-up among patients who did not experience relapse based on 12-month all-cause costs (GPA, $32,005 [SD, $64,570]; MPA, $61,044 [SD, $125,093]).
Relapses are common among patients with GPA and MPA, and treatment of relapses can be costly. More effective therapies are needed to prevent relapses.
Genentech, Inc.
肉芽肿性多血管炎（GPA）和显微镜下多血管炎（MPA）是两种相关的系统性血管炎形式。患有这些疾病的患者经常经历影响身体各个系统的复发。在此，我们描述复发率，并回顾GPA/MPA患者复发所产生的医疗费用。
基于诊断编码，从2011年至2013年的MarketScan索赔数据库中选取两组GPA和MPA患者。对患者进行12个月的随访，根据医疗和药物索赔中的诊断算法确定复发情况。复发被分为以下几组之一：肾脏复发、肺部复发、其他与复发相关的疾病复发、GPA或MPA使用复发以及混合复发。
GPA和MPA患者的最终样本分别包括2707例和740例患者。在两组中，约四分之一的患者在12个月的随访期内经历了复发。复发后4个月内的平均全因医疗费用，GPA患者为38,313美元（标准差为54,120美元），MPA患者为35,947美元（标准差为48,065美元）。在两组中，肾脏复发的费用最高。复发后紧接着的4个月内的费用显著高于根据12个月全因费用未经历复发的患者在4个月随访期间的预期费用（GPA为32,005美元[标准差为64,570美元]；MPA为61,044美元[标准差为125,093美元]）。
复发在GPA和MPA患者中很常见，且复发的治疗费用可能很高。需要更有效的治疗方法来预防复发。
基因泰克公司
