Health Economics Department, Janssen Pharmaceutical K.K., Tokyo, Japan.
Medical Science Liaison Department, Medical Affairs, Janssen Pharmaceutical K.K., Tokyo, Japan.
Adv Ther. 2021 May;38(5):2229-2247. doi: 10.1007/s12325-020-01615-4. Epub 2021 Jan 30.
The prevalence of ulcerative colitis (UC) is increasing in Japan but recent disease burden estimates are unavailable. This study was conducted to explore the prescription pattern and to estimate the economic burden in Japanese patients with UC.
This retrospective cohort study was conducted from 1 January 2009 to 30 June 2018 using healthcare claims data from the Japan Medical Data Center (JMDC) database. Patients with a UC diagnosis before the index date (the first UC treatment claim) or within 6 months after the index date, a UC treatment claim registered within ≥ 6 months during the selection period, and a continuous enrollment for 6 months pre-index and 12 months follow-up period were included in the study. Prescription pattern was analyzed by calendar years and lines of treatment (LoT). Healthcare resource utilization and cost per month were determined by LoTs.
Among 10,337 patients with UC diagnosis, 1,861 (18.0%) met the eligibility criteria for this study. 5-Aminosalicylic acid (5-ASA) was the most used treatment over the study period and across all LoTs. 5-ASA was also the most prescribed treatment (88.7%) across all the first LoTs, followed by steroids (20.4%). Use of biologics increased over the study period (biologics + 5-ASA: 0.0% in 2009 to 3.0% in 2018). Biologics were most used as the sixth LoT (7.1%, biologics + 5-ASA; 7.1%, biologics + 5-ASA + steroids). Mean total cost per month was JPY 52,782, with the highest (JPY 112,997) total healthcare cost per month in the fourth LoT and the lowest in the first LoT (JPY 56,782).
Prescription pattern in Japanese patients with UC enrolled in the JMDC database were largely consistent with the clinical guidelines in Japan. UC puts a substantial economic burden on patients, and an effective treatment is warranted to reduce the UC disease burden.
溃疡性结肠炎（UC）在日本的患病率正在上升，但最近的疾病负担估计数据尚不可用。本研究旨在探讨日本 UC 患者的处方模式并评估其经济负担。
本回顾性队列研究使用日本医疗数据中心（JMDC）数据库中的医疗保健索赔数据，于 2009 年 1 月 1 日至 2018 年 6 月 30 日进行。符合以下条件的患者纳入研究：在索引日期（首次 UC 治疗索赔）之前或索引日期后 6 个月内患有 UC 诊断；索引日期前 6 个月内在选择期间内注册至少 1 次 UC 治疗索赔；并且在索引前 6 个月和随访 12 个月期间连续入组。通过日历年度和治疗线（LoT）分析处方模式。根据 LoT 确定每月的医疗资源利用和费用。
在 10337 例 UC 诊断患者中，有 1861 例（18.0%）符合本研究的纳入标准。5-氨基水杨酸（5-ASA）是整个研究期间和所有 LoT 中使用最广泛的治疗方法。5-ASA 也是所有一线 LoT 中最常开具的治疗方法（88.7%），其次是类固醇（20.4%）。研究期间生物制剂的使用有所增加（生物制剂+5-ASA：2009 年为 0.0%，2018 年为 3.0%）。生物制剂主要作为第六线 LoT 使用（7.1%，生物制剂+5-ASA；7.1%，生物制剂+5-ASA+类固醇）。每月的总费用为 52782 日元，第四线 LoT 的总医疗费用最高（112997 日元），而第一线 LoT 的总医疗费用最低（56782 日元）。
在 JMDC 数据库中登记的日本 UC 患者的处方模式与日本的临床指南基本一致。UC 给患者带来了巨大的经济负担，需要有效的治疗方法来减轻 UC 的疾病负担。
