Yamabe Kaoru, Liebert Ryan, Flores Natalia, Pashos Chris
a Takeda Pharmaceutical Company Limited , Tokyo , Japan.
b Kantar Health , New York , NY , USA.
J Med Econ. 2018 Dec;21(12):1206-1212. doi: 10.1080/13696998.2018.1522638. Epub 2018 Oct 1.
This study aimed to characterize the burden of Parkinson's disease (PD) by examining health-related quality-of-life (HRQoL), impairments to work productivity and daily activities, healthcare resource use, and associated costs among Japanese patients with PD.
This retrospective cross-sectional study used data from the 2009-2014 Japan National Health and Wellness Survey (NHWS) (n = 144,692). HRQoL (Short Form 36-Item Health Survey version 2), impairments to work productivity and daily activities (Work Productivity and Activity Impairment Questionnaire), healthcare resource utilization, and annual costs were compared between respondents with PD (n = 133) and controls without PD (n = 144,559). The effect of PD on outcomes was estimated using propensity score weighting and multivariable regression models.
HRQoL was lower in patients with PD compared to the control group, with reduced physical (41.3 vs 51.3) and mental (35.7 vs 45.4) component summary scores and health state utility scores (0.62 vs 0.77; p < .001 for all). Patients with PD also reported higher levels of absenteeism (19.3% vs 3.3%), presenteeism (45.2% vs 18.5%), overall work impairment (52.8% vs 20.3%), and activity impairment (49.6% vs 20.8%) than controls without PD (p < .001 for all). In addition, patients with PD had higher healthcare resource utilization, direct (¥3,856,921/$37,994 vs ¥715,289/$7,046), and indirect (¥2,573,938/$25,356 vs ¥902,534/$8,891) costs compared with controls without PD (p < .001 for both).
Data were cross-sectional and did not allow for causal inferences. Although the NHWS demographically represents the Japanese adult population, it is unclear whether it adequately represents the adult population with PD in Japan.
PD was associated with poorer HRQoL, greater work productivity loss, and higher direct and indirect costs. The findings suggest that an unmet need exists among patients with PD in Japan. Improving PD treatment and management could benefit both patients and society.
本研究旨在通过调查日本帕金森病（PD）患者的健康相关生活质量（HRQoL）、工作生产力和日常活动障碍、医疗资源使用情况以及相关成本，来描述帕金森病的负担。
这项回顾性横断面研究使用了2009 - 2014年日本国民健康与福祉调查（NHWS）的数据（n = 144,692）。比较了PD患者（n = 133）和无PD的对照组（n = 144,559）在HRQoL（简明健康调查问卷第2版）、工作生产力和日常活动障碍（工作生产力与活动障碍问卷）、医疗资源利用情况以及年度成本方面的差异。使用倾向得分加权和多变量回归模型估计PD对各项结果的影响。
与对照组相比，PD患者的HRQoL较低，身体（41.3对51.3）和精神（35.7对45.4）成分汇总得分以及健康状态效用得分均降低（分别为0.62对0.77；所有p < 0.001）。PD患者的旷工率（19.3%对3.3%）、出勤但工作效率低下率（45.2%对18.5%）、总体工作障碍率（52.8%对20.3%）和活动障碍率（49.6%对20.8%）也高于无PD的对照组（所有p < 0.001）。此外，与无PD的对照组相比，PD患者的医疗资源利用率更高，直接成本（3,856,921日元/37,994美元对715,289日元/7,046美元）和间接成本（2,573,938日元/25,356美元对902,534日元/8,891美元）也更高（两者p < 0.001）。
数据为横断面数据，不允许进行因果推断。尽管NHWS在人口统计学上代表了日本成年人口，但尚不清楚它是否能充分代表日本患有PD的成年人口。
PD与较差的HRQoL、更大的工作生产力损失以及更高的直接和间接成本相关。研究结果表明，日本PD患者存在未满足的需求。改善PD的治疗和管理对患者和社会都有益处。
