台湾接受高效抗逆转录病毒治疗的 HIV 感染患者合并症的患病率及相关药物费用：一项横断面研究。

Prevalence and related drug cost of comorbidities in HIV-infected patients receiving highly active antiretroviral therapy in Taiwan: A cross-sectional study.

机构信息

Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.

Medical Affairs, Janssen Pharmaceuticals, Taiwan.

出版信息

J Microbiol Immunol Infect. 2019 Oct;52(5):720-727. doi: 10.1016/j.jmii.2019.05.011. Epub 2019 Jul 5.

DOI:10.1016/j.jmii.2019.05.011

PMID:31358463

Abstract

BACKGROUND

To determine the prevalence of chronic comorbidities and associated medication costs in Taiwanese HIV patients in order to increase awareness of the disease burden among healthcare providers and patients.

METHODS

HIV-diagnosed patients receiving highly active antiretroviral therapy (HAART; 2010-2013) were identified from the Taiwan National Health Insurance Research Database with the corresponding International Classification of Diseases, ninth revision (ICD-9) code. Comorbidities (type II diabetes mellitus, hypertension, dyslipidemia, major depressive disorder, acute coronary syndrome, and cholelithiasis/nephrolithiasis) were identified according to ICD-9 or relevant medication use. Comorbidity medication and associated costs were identified using the drug classification code from the Anatomical Therapeutic Chemical classification system code series and series outpatient prescriptions.

RESULTS

Of 20,726 HIV-diagnosed Taiwanese patients (2010-2013), 13,142 receiving HAART were analyzed. Prevalence of all chronic comorbidities was significantly greater (p < 0.0001) in patients aged ≥40 years versus <40 years (diabetes mellitus, 14.95% vs. 3.30%; hypertension, 46.73% vs. 26.83%; dyslipidemia, 34.93% vs. 18.37%; depression, 23.75% vs. 19.88%; acute coronary syndrome, 1.16% vs. 0.21%; nephrolithiasis/cholelithiasis, 7.26% vs. 4.56%; >2 comorbidities, 24.80% vs. 7.21%). An increase in comorbidity medication spending (2010 vs. 2013 medication costs) was observed (antidyslipidemia, $88,878 vs. $168,180; antihyperglycemia, $32,372 vs. $73,518; antidepressants, $78,220 vs. $125,971; sedatives, $60,009 vs. $85,055; antihypertension, $47,115 vs. $95,134), contributing to overall treatment costs increasing almost two-fold from 2010 to 2013.

CONCLUSIONS

Among HIV-infected Taiwanese patients receiving HAART, significant increases in comorbidity prevalence with age, along with rising comorbidity medication costs, suggest the need for preventative as well as chronic care.

摘要

背景

为了提高医疗保健提供者和患者对疾病负担的认识，确定台湾 HIV 患者的慢性合并症患病率和相关药物治疗费用。

方法

从台湾全民健康保险研究数据库中使用相应的国际疾病分类，第九修订版（ICD-9）代码识别出接受高效抗逆转录病毒治疗（HAART；2010-2013 年）的 HIV 确诊患者。根据 ICD-9 或相关药物使用情况确定合并症（2 型糖尿病、高血压、血脂异常、重度抑郁症、急性冠状动脉综合征和胆石症/肾结石）。使用药物分类代码从解剖治疗化学分类系统代码系列和系列门诊处方确定合并症药物和相关费用。

结果

在 20726 名 HIV 确诊的台湾患者（2010-2013 年）中，分析了 13142 名接受 HAART 的患者。年龄≥40 岁的患者与<40 岁的患者相比，所有慢性合并症的患病率均显著更高（p<0.0001）（糖尿病，14.95% vs. 3.30%；高血压，46.73% vs. 26.83%；血脂异常，34.93% vs. 18.37%；抑郁症，23.75% vs. 19.88%；急性冠状动脉综合征，1.16% vs. 0.21%；肾结石/胆石症，7.26% vs. 4.56%；合并症≥2 种，24.80% vs. 7.21%）。观察到合并症药物治疗费用的增加（2010 年与 2013 年药物费用）（抗血脂异常药物，88878 美元 vs. 168180 美元；抗高血糖药物，32372 美元 vs. 73518 美元；抗抑郁药，78220 美元 vs. 125971 美元；镇静剂，60009 美元 vs. 85055 美元；抗高血压药物，47115 美元 vs. 95134 美元），导致 2010 年至 2013 年期间治疗总成本几乎翻了一番。