Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Japan.
Pfizer Japan Inc., Tokyo, Japan.
Clin Drug Investig. 2020 Nov;40(11):1071-1084. doi: 10.1007/s40261-020-00968-6.
The guidelines for osteoarthritis (OA) treatment recommend different therapies including pharmacotherapy, and several analgesic options are available for pain management. In Japan, research on hip and knee OA treatment trends is scarce and OA-related healthcare costs are unknown. Therefore, this study aimed to examine the treatment and healthcare cost trends among Japanese patients with hip or knee OA.
This was a cross-sectional study held between 2013 and 2019, using a medical claims database. The demographic and treatment characteristics of hip or knee OA patients for each year were descriptively analyzed and the medians for healthcare utilization and all-cause healthcare costs were calculated.
The yearly mean age of 59,218 hip OA and 270,722 knee OA patients ranged from 66.3 to 68.6 years and 71.1 to 73.1 years, respectively. The prevalence of comorbidities was higher in knee OA than hip OA. In both groups, > 70% of patients were female, and the most common treatment was pain-related medication. In hip OA, topical and systemic nonsteroidal anti-inflammatory drugs (NSAIDs) were mostly used throughout the study period (34.1-41.4% and 32.0-40.3%, respectively). Similarly, in knee OA, topical and systemic NSAIDs were used in 58.3-63.3% and 36.5-46.0% patients, respectively. Increase in the use of acetaminophens (10.9% in hip OA and 10.2% in the knee OA) and weak opioids (3.7%, and 3.4%, respectively) from 2013 to 2019 were observed. Most patients were treated as outpatients in both groups. The median all-cause healthcare costs were approximately 35,000 JPY for hip OA and 74,000 JPY for knee OA.
Although a considerable change in total healthcare cost was not observed in our study, the contents of medical treatment and cost breakdown were greatly altered due to the treatment and cost for OA itself, and the treatment and cost for comorbidities. Similar studies to investigate such a trend may help predict necessary resources and social needs. Thus, further investigation utilizing other databases is needed.
骨关节炎（OA）治疗指南推荐了多种治疗方法，包括药物治疗，并且有多种镇痛选择可用于疼痛管理。在日本，关于髋部和膝部 OA 治疗趋势的研究很少，OA 相关的医疗保健费用也不清楚。因此，本研究旨在研究日本髋部或膝部 OA 患者的治疗和医疗保健费用趋势。
这是一项横断面研究，于 2013 年至 2019 年期间使用医疗索赔数据库进行。对每年髋部或膝部 OA 患者的人口统计学和治疗特征进行描述性分析，并计算医疗保健利用和全因医疗保健费用的中位数。
59218 例髋部 OA 和 270722 例膝部 OA 患者的每年平均年龄范围分别为 66.3 至 68.6 岁和 71.1 至 73.1 岁。膝部 OA 的合并症患病率高于髋部 OA。在这两组患者中，超过 70%的患者为女性，最常见的治疗方法是与疼痛相关的药物治疗。在髋部 OA 中，局部和全身非甾体抗炎药（NSAIDs）在整个研究期间的使用率最高（分别为 34.1%至 41.4%和 32.0%至 40.3%）。同样，在膝部 OA 中，58.3%至 63.3%和 36.5%至 46.0%的患者分别使用局部和全身 NSAIDs。2013 年至 2019 年间，观察到对乙酰氨基酚（髋部 OA 中 10.9%，膝部 OA 中 10.2%）和弱阿片类药物（分别为 3.7%和 3.4%）的使用率增加。两组患者均以门诊治疗为主。髋部 OA 的全因医疗保健费用中位数约为 35000 日元，膝部 OA 的全因医疗保健费用中位数约为 74000 日元。
尽管本研究未观察到总医疗保健费用的显著变化，但由于 OA 本身以及合并症的治疗和费用，医疗治疗和费用的内容发生了很大变化。进行类似的研究以调查这种趋势可能有助于预测所需的资源和社会需求。因此，需要利用其他数据库进行进一步研究。
