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日本强直性脊柱炎患者的治疗模式与医疗资源利用情况:一项医院索赔数据库分析。

Treatment patterns and health care resource utilization among Japanese patients with ankylosing spondylitis: A hospital claims database analysis.

作者信息

Tomita Tetsuya, Sato Masayo, Esterberg Elizabeth, Parikh Rohan C, Hagimori Kohei, Nakajo Ko

机构信息

Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Osaka, Japan.

Eli Lilly Japan K.K, Kobe, Japan.

出版信息

Mod Rheumatol. 2021 Mar;31(2):431-441. doi: 10.1080/14397595.2020.1775927. Epub 2020 Jun 19.

Abstract

OBJECTIVES

To understand the current state of treatment patterns and health care resource utilization among patients in Japan with ankylosing spondylitis (AS) managed in the real-world setting.

METHODS

Patient records from the Medical Data Vision database were analyzed to identify patients with ICD-10 AS from April 2009 through July 2017. Measures evaluated included demographic, clinical, and other characteristics at diagnosis; treatment patterns; health care resource utilization; and costs.

RESULTS

Four hundred and seventeen patients met the study's inclusion criteria. Treatments observed during the first year after the initial AS diagnosis included nonsteroidal anti-inflammatory drugs (79.6%), corticosteroids (39.3%), methotrexate (22.3%), sulfasalazine (16.8%), adalimumab (14.2%), and infliximab (12.2%). At any time during the mean 33 months of study follow-up, biologic disease-modifying antirheumatic drugs (bDMARDs) were initiated by 115 patients. During the study follow-up, patients who initiated bDMARDs had higher median total per-patient annual health care costs ($26,937 vs $15,323), lower median per-patient hospitalization costs ($29,817 vs. $39,509), and fewer median hospital days per admission (7.0 vs. 11.0 days) compared with the overall group of patients diagnosed with AS.

CONCLUSION

This database study provides knowledge of patient characteristics, treatment patterns, HCRU, and costs for patients with AS in Japan. The study outcomes demonstrate a need for increased awareness of proper AS management.

摘要

目的

了解在现实环境中接受治疗的日本强直性脊柱炎(AS)患者的治疗模式现状和医疗资源利用情况。

方法

分析医疗数据视觉数据库中的患者记录,以识别2009年4月至2017年7月期间患有国际疾病分类第十版(ICD - 10)AS的患者。评估的指标包括诊断时的人口统计学、临床和其他特征;治疗模式;医疗资源利用情况;以及费用。

结果

417名患者符合研究纳入标准。在首次AS诊断后的第一年观察到的治疗方法包括非甾体抗炎药(79.6%)、皮质类固醇(39.3%)、甲氨蝶呤(22.3%)、柳氮磺胺吡啶(16.8%)、阿达木单抗(14.2%)和英夫利昔单抗(12.2%)。在平均33个月的研究随访期间的任何时间,115名患者开始使用生物改善病情抗风湿药物(bDMARDs)。在研究随访期间,与诊断为AS的总体患者组相比,开始使用bDMARDs的患者的每位患者每年总医疗费用中位数更高(26,937美元对15,323美元),每位患者住院费用中位数更低(29,817美元对39,509美元),每次入院的住院天数中位数更少(7.0天对11.0天)。

结论

这项数据库研究提供了日本AS患者的患者特征、治疗模式、医疗资源利用情况和费用方面的知识。研究结果表明需要提高对AS合理管理的认识。

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