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新诊断多发性骨髓瘤患者干细胞移植后生产力损失和维持治疗的影响。

Productivity losses in patients with newly diagnosed multiple myeloma following stem cell transplantation and the impact of maintenance therapy.

机构信息

Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.

Myeloma UK, Edinburgh, UK.

出版信息

Eur J Haematol. 2019 Oct;103(4):393-401. doi: 10.1111/ejh.13298. Epub 2019 Aug 12.

Abstract

OBJECTIVE

This study examined productivity losses in European patients with newly diagnosed multiple myeloma (NDMM) undergoing autologous stem cell transplantation (ASCT), to better understand and model the impact of NDMM and lenalidomide maintenance therapy on productivity from a patient and societal perspective.

METHODS

A cross-sectional online patient survey was conducted across the UK, Germany, France, Spain and Italy. A partitioned survival model was used to estimate productivity loss and the impact of maintenance therapy, using human capital (HC) and friction cost approaches.

RESULTS

Of the 115 eligible survey respondents, 76.5% were economically active at the time of diagnosis and highlighted return to work as an important factor affecting their quality of life; only 39.1% of respondents were economically active post-ASCT. HC analyses estimated average total productivity losses per ASCT patient at EUR 290,601 over a 20-year period. Modelling the impact of maintenance therapy alone for these patients reduced average productivity losses by just over 10%.

CONCLUSION

Patients with NDMM aspire to engage in productive lives post-ASCT, but most are unable to do so. Access to treatments extending remission and supporting engagement in a productive life can have a positive impact both for patients and wider society.

摘要

目的

本研究旨在评估新诊断多发性骨髓瘤(NDMM)患者接受自体干细胞移植(ASCT)后的生产力损失,以从患者和社会角度更好地理解和建模 NDMM 及来那度胺维持治疗对生产力的影响。

方法

在英国、德国、法国、西班牙和意大利进行了一项跨部门的在线患者调查。使用分割生存模型,采用人力资本(HC)和摩擦成本方法来估计生产力损失和维持治疗的影响。

结果

在 115 名符合条件的调查参与者中,76.5%在诊断时处于经济活跃状态,并强调重返工作岗位对其生活质量的重要影响;只有 39.1%的受访者在 ASCT 后仍保持经济活跃。HC 分析估计,每位 ASCT 患者在 20 年内的平均总生产力损失为 290601 欧元。仅对这些患者进行维持治疗的影响建模,就可将平均生产力损失减少 10%以上。

结论

患有 NDMM 的患者渴望在 ASCT 后从事有生产力的生活,但大多数人无法做到这一点。提供延长缓解期和支持从事有生产力的生活的治疗方法,可以对患者和更广泛的社会产生积极影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2387/6899492/8b95aea736b0/EJH-103-393-g001.jpg

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