Pérez-Hernández Concepción, Jiménez-López Antonio Javier, Sanz-Yagüe Almudena, Mar-Medina Javier, Larrañaga Igor, Soler-López Begoña
Pain Unit, Hospital Universitario de la Princesa, Madrid, Spain.
Medical Department, Kyowa Kirin Farmacéutica, S.L.U, Madrid, Spain.
Pain Ther. 2018 Dec;7(2):227-240. doi: 10.1007/s40122-018-0102-0. Epub 2018 Jul 5.
Breakthrough pain (BTP) has great repercussions on the quality of life, and on the use of health resources. The scope of BTP costs in cancer patients is unknown. The purpose of this study was to evaluate the economic cost of BTP in patients with cancer and the relationship with their quality of life.
A 1-month observational prospective cost-of-illness study was designed. The patients recorded the consumption of health resources and drugs related to BTP in a diary. The current symptoms in Edmonton Symptoms Assessment Scale (ESAS) and their quality of life (EORTC QLQ-C30, version 3) were assessed. The direct medical and non-medical costs fixed and variable and the indirect costs of the patient and the caregivers were evaluated. Factors related to cost and quality of life were identified using linear generalized models (LGM) type gamma and logistic link. Participants were oncologic patients with BTP, older than 18 years, with controlled basal pain.
Eight Spanish pain units, eight palliative care units, and one oncology department included 152 patients. One hundred patients (65.8%) were male and the mean age was 66.8 years (95% CI 64.8-68.8). The total cost per patient was 2941.60 euros per month: 88% direct medical costs, 5% non-medical direct costs, and 7% indirect costs due to lost productivity. A better score in EORTC QLQ-30 quality of life was associated with a reduction in overall costs.
The study showed the results of the first real-life prospective study evaluating the cost of illness of BTP in cancer patients demonstrating that the presence of breakthrough pain in a cancer patient causes a very significant increase in healthcare costs.
Kyowa Kirin Farmacéutica, S.L.U.
爆发性疼痛（BTP）对生活质量和卫生资源的使用有重大影响。癌症患者中BTP的成本范围尚不清楚。本研究的目的是评估癌症患者中BTP的经济成本及其与生活质量的关系。
设计了一项为期1个月的观察性前瞻性疾病成本研究。患者在日记中记录与BTP相关的卫生资源和药物消耗情况。评估了埃德蒙顿症状评估量表（ESAS）中的当前症状及其生活质量（欧洲癌症研究与治疗组织生活质量问卷C30，第3版）。评估了直接医疗和非医疗固定及可变成本以及患者和护理人员的间接成本。使用伽马型线性广义模型（LGM）和逻辑链接确定与成本和生活质量相关的因素。参与者为年龄超过18岁、基础疼痛得到控制的患有BTP的肿瘤患者。
八个西班牙疼痛科、八个姑息治疗科和一个肿瘤科纳入了152名患者。100名患者（65.8%）为男性，平均年龄为66.8岁（95%置信区间64.8 - 68.8）。每位患者每月的总成本为2941.60欧元：88%为直接医疗成本，5%为非医疗直接成本，7%为因生产力损失导致的间接成本。欧洲癌症研究与治疗组织生活质量问卷C30生活质量得分越高，总体成本越低。
该研究展示了第一项评估癌症患者BTP疾病成本的真实生活前瞻性研究结果，表明癌症患者中爆发性疼痛的存在会导致医疗保健成本大幅增加。
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