Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden.
AstraZeneca Nordic-Baltic, Södertälje, Sweden.
Respir Med. 2020 Feb;162:105860. doi: 10.1016/j.rmed.2019.105860. Epub 2020 Jan 2.
The aim of the present study was to estimate the societal costs and the key cost drivers for patients with severe asthma in Sweden. In addition, health-related quality of life (HRQOL) and morbidity of patients with severe asthma is described.
The study population comprised adults with severe asthma recruited from a large asthma cohort within the Obstructive Lung Disease in Northern Sweden (OLIN) studies. During 2017, patients were interviewed quarterly over telephone regarding their resource utilization and productivity losses.
Estimated mean annual asthma-related costs per patient with severe asthma amounted to €6,500, of which approximately €2400 and €4100 were direct and indirect costs, respectively. The main cost drivers for direct costs were hospitalizations followed by drugs: approximately €1000 and €800, respectively. Patients on treatment with regular oral corticosteroids (OCS) had greater direct costs compared with those without regular OCS treatment. Co-morbid conditions were common and the costs were substantial also for co-morbid conditions, with a total cost of approximately €4200. The OCS group had significantly lower HRQOL compared to the non-OCS group.
The societal costs due to severe asthma were substantial. Costs for co-morbid conditions contributed substantially to both direct and indirect costs. The direct costs were significantly higher in the maintenance OCS-group compared to the non-maintenance OCS-group. These results indicate a need for improved management and treatment regimens for patients with severe asthma.
本研究旨在估算瑞典重度哮喘患者的社会成本和主要成本驱动因素。此外，还描述了重度哮喘患者的健康相关生活质量（HRQOL）和发病率。
研究人群包括从北方瑞典阻塞性肺病（OLIN）研究中的大型哮喘队列中招募的患有重度哮喘的成年人。在 2017 年期间，通过电话每季度对患者进行资源利用和生产力损失访谈。
估计每名重度哮喘患者的年平均哮喘相关费用为 6500 欧元，其中直接成本约为 2400 欧元，间接成本约为 4100 欧元。直接成本的主要成本驱动因素是住院治疗，其次是药物治疗：分别约为 1000 欧元和 800 欧元。接受常规口服皮质类固醇（OCS）治疗的患者的直接成本明显高于未接受常规 OCS 治疗的患者。合并症很常见，合并症的费用也很高，约为 4200 欧元。OCS 组的 HRQOL 明显低于非 OCS 组。
由于重度哮喘引起的社会成本很高。合并症的成本对直接成本和间接成本都有很大的贡献。与非维持 OCS 组相比，维持 OCS 组的直接成本明显更高。这些结果表明需要改善对重度哮喘患者的管理和治疗方案。
