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美国多发性硬化症的平民非住院患者的边缘医疗支出负担:2010-2015 年。

Marginal Health Care Expenditure Burden Among U.S. Civilian Noninstitutionalized Individuals with Multiple Sclerosis: 2010-2015.

机构信息

Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, Texas.

Baylor College of Medicine, Houston, Texas.

出版信息

J Manag Care Spec Pharm. 2020 Jun;26(6):741-749. doi: 10.18553/jmcp.2020.26.6.741.

Abstract

BACKGROUND

Multiple sclerosis (MS) is a chronic neuroinflammatory disorder with significant health care burden. However, little is known about health care expenditures since the introduction of oral agents for MS after 2010.

OBJECTIVE

To analyze health care expenditures in individuals with MS using Medical Expenditure Panel Survey (MEPS) data from 2010-2015.

METHODS

This retrospective cross-sectional study included adults (≥ 18 years) with MS (Clinical Classification Code 080) and those without MS based on the 2010-2015 full year consolidated MEPS Household Component and Medical Provider Component data files. Descriptive weighted analyses were performed to compare health care expenditures between individuals with MS and without MS. The 2-part model involving probit and generalized linear models was used to estimate the marginal increase in total health care expenditures for MS patients.

RESULTS

There were 0.61 million patients (95% CI = 0.50-0.72) diagnosed with MS annually, accounting for a prevalence of 0.25%. The 2-part model revealed that the marginal total health care expenditures in patients diagnosed with MS were $20,103.49 (95% CI = $14,516.24-$25,690.73) more compared with those without MS. Further, the mean adjusted prescription medication expenditures for the MS group were $13,092.16 (95% CI = $9,452.20-$16,732.12) higher than the non-MS group and accounted for 65.12% of total health care expenditures in MS.

CONCLUSIONS

MS is an expensive neuroinflammatory disease with a majority of the burden attributable to prescription medications. High prescription expenditure burden can be a barrier to optimal patient care in MS.

DISCLOSURES

No funding was received for this study. Hutton reports grants from Adamas, Biogen, EMD Serono, Genzyme, Hoffman-LaRoche, MedImmune, Mallinckrodt, and Novartis and fees from Biogen, Celgene, Genzyme, Genentech, and Novartis, outside the submitted work. Aparasu reports grants from Novartis, Incyte, and Astellas, outside the submitted work. Earla and Thornton have nothing to disclose. Part of the study findings was presented at the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) 2019 National Conference; May 18-22, 2019; New Orleans, LA.

摘要

背景

多发性硬化症(MS)是一种慢性神经炎症性疾病,对医疗保健造成了重大负担。然而,自 2010 年以来,用于治疗多发性硬化症的口服药物问世后,关于医疗保健支出的信息却很少。

目的

使用 2010-2015 年的医疗支出面板调查(MEPS)数据,分析多发性硬化症患者的医疗保健支出。

方法

本回顾性横断面研究纳入了基于 2010-2015 年全年合并的 MEPS 家庭部分和医疗服务提供者部分数据文件的患有 MS(临床分类代码 080)和未患 MS 的成年人(≥18 岁)。采用描述性加权分析比较了 MS 患者和非 MS 患者的医疗保健支出。采用两部分模型(涉及概率单位和广义线性模型)估计 MS 患者总医疗保健支出的边际增量。

结果

每年有 0.61 百万患者(95%CI=0.50-0.72)被诊断为 MS,其患病率为 0.25%。两部分模型显示,与未患 MS 的患者相比,诊断为 MS 的患者的边际总医疗保健支出高出 20,103.49 美元(95%CI=14,516.24-25,690.73)。此外,MS 组的平均调整后的处方药物支出比非 MS 组高 13,092.16 美元(95%CI=9,452.20-16,732.12),占 MS 患者总医疗保健支出的 65.12%。

结论

MS 是一种昂贵的神经炎症性疾病,大部分负担归因于处方药物。高昂的处方支出负担可能成为 MS 患者最佳治疗的障碍。

披露

本研究未获得资金支持。Hutton 报告说,他从 Adamas、Biogen、EMD Serono、Genzyme、Hoffman-LaRoche、MedImmune、Mallinckrodt 和 Novartis 获得了资助,并从 Biogen、Celgene、Genzyme、Genentech 和 Novartis 获得了报酬,这些都与提交的工作无关。Aparasu 报告说,他从 Novartis、Incyte 和 Astellas 获得了资助,这些都与提交的工作无关。Earla 和 Thornton 没有需要披露的信息。该研究结果的一部分在国际药物经济学与结果研究学会(ISPOR)2019 年国家会议上公布;2019 年 5 月 18-22 日;新奥尔良,LA。

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