Bloom B S
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia 19104-6020.
Aliment Pharmacol Ther. 1988;2 Suppl 1:131-8. doi: 10.1111/j.1365-2036.1988.tb00772.x.
Non-steroidal anti-inflammatory drugs (NSAIDs) are efficacious in the treatment of arthritis. However, side-effects particularly gastrointestinal toxicity, have been well documented with their use. Thus, in assessing total direct medical costs in the treatment of arthritis, the expenses involved in treating these side-effects must be taken into account. A retrospective analysis was undertaken of all direct medical costs related to care of a group of Medicaid recipients treated for arthritis during a 2-year period. Data were obtained from the Medicaid Management Information System of Washington, D.C., USA. The actual expenditure of treating arthritis as well as the medical costs of associated NSAID-induced gastrointestinal side-effects were determined. Arthritis treatment costs per quarter were found to be $145 per patient. Approximately 25% of the population experienced NSAID-related gastrointestinal side-effects requiring further medical care. Treatment of these adverse effects costs an additional $66 per quarter per patient, thus adding 45.5% to the cost of arthritis treatment. Pharmaceutical claims comprised 42.4% of total adverse drug reaction treatment costs, while the few hospital claims accounted for 37.9% and physician charges 19.7%. It has been estimated that in 1983 direct medical costs of arthritis treatment in the USA was $8.6 billion. By extrapolating the costs in this study, it can be estimated that a further $3.9 billion was spent on treating gastrointestinal side-effects of NSAIDs, making a total of $12.5 billion.
非甾体抗炎药（NSAIDs）在关节炎治疗中疗效显著。然而，其副作用尤其是胃肠道毒性，已有充分记录。因此，在评估关节炎治疗的总直接医疗成本时，必须考虑治疗这些副作用所涉及的费用。对一组在两年期间接受关节炎治疗的医疗补助接受者的所有直接医疗成本进行了回顾性分析。数据来自美国华盛顿特区的医疗补助管理信息系统。确定了治疗关节炎的实际支出以及与非甾体抗炎药引起的胃肠道副作用相关的医疗成本。发现每位患者每季度的关节炎治疗成本为145美元。约25%的人群出现了与非甾体抗炎药相关的胃肠道副作用，需要进一步治疗。治疗这些不良反应每位患者每季度额外花费66美元，从而使关节炎治疗成本增加了45.5%。药品索赔占药物不良反应治疗总成本的42.4%，而少数住院索赔占37.9%，医生收费占19.7%。据估计，1983年美国关节炎治疗的直接医疗成本为86亿美元。通过推断本研究中的成本，可以估计在治疗非甾体抗炎药的胃肠道副作用上又花费了39亿美元，总计125亿美元。
