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血友病患者 6 个月程控运动疗法(PST)的成本-效用分析。

Cost-utility of a six-month programmed sports therapy (PST) in patients with haemophilia.

机构信息

Center for Health Economics and Health Services Research, University of Wuppertal, Wuppertal, Germany.

Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany.

出版信息

Haemophilia. 2018 May;24(3):385-394. doi: 10.1111/hae.13459. Epub 2018 Mar 30.

Abstract

INTRODUCTION

Recurrent musculoskeletal haemorrhages in people with haemophilia (PwH) lead to restrictions in the locomotor system and, as a result, in physical performance, too. Due to its physical and psychological benefits, sport is increasingly re-commended for haemophilic patients. Evidence on the cost-effectiveness of sports therapy is still lacking.

AIM

The aim of this study was to determine the cost-effectiveness of a 6-month programmed sports therapy (PST).

METHODS

The cost-effectiveness of the 6-month PST was assessed from a societal perspective alongside a RCT using cost-utility analysis. The analysis included 50 PwH with moderate-to-severe haemophilia A and B and a training period over 6 months. The health-related quality of life was measured with the EuroQoL-domain questionnaire. Resource utilization was assessed by questionnaire before and after the intervention. A cost-effectiveness acceptability curve was constructed, and sensitivity analyses were performed.

RESULTS

During the 6-month study period, mean adjusted total healthcare costs were lower (mean difference: -22 805 EUR; 95%-CI: -73 944-48 463; P = .59) and the number of QALYs was higher in the intervention group (mean difference: 0.3733; 95%-CI: 0.0014-0.0573; P = .04). The probability of an incremental cost-effectiveness ratio <50 000 EUR per QALY was 71%. The performed sensitivity analysis confirmed these results.

CONCLUSION

Results showed that the PST is effective in terms of a significant gain of QALYs. Furthermore, results weakly indicate the potential of the PST to reduce healthcare costs. Future studies should expand the observation period to have a closer look at the influence of PST on lifetime costs.

摘要

简介

患有血友病(PwH)的人会反复出现肌肉骨骼出血,这会导致运动系统受限,进而影响身体机能。由于运动具有生理和心理上的益处,因此越来越多的血友病患者被建议参加运动。但目前仍缺乏有关运动疗法成本效益的证据。

目的

本研究旨在确定 6 个月程序化运动疗法(PST)的成本效益。

方法

采用 RCT 联合成本效用分析,从社会角度评估 6 个月 PST 的成本效益。该分析纳入了 50 名患有中重度血友病 A 和 B 的 PwH,并进行了为期 6 个月的训练。使用 EuroQoL 量表评估健康相关生活质量。干预前后通过问卷评估资源利用情况。构建成本效益接受曲线,并进行敏感性分析。

结果

在 6 个月的研究期间,干预组的平均调整后总医疗保健成本较低(平均差异:-22805 欧元;95%CI:-73944-48463;P=0.59),且 QALY 更高(平均差异:0.3733;95%CI:0.0014-0.0573;P=0.04)。增量成本效益比低于 50000 欧元/QALY 的概率为 71%。敏感性分析结果证实了这些结果。

结论

结果表明,PST 在提高 QALY 方面具有显著效果。此外,结果还表明 PST 有潜力降低医疗保健成本。未来的研究应延长观察期,以更深入地了解 PST 对终生成本的影响。

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