Colombo Giorgio Lorenzo, Heiman Franca, Peduto Ilaria
CEFAT - Department of Drug Sciences, University of Pavia, Pavia, Italy.
Real World Solutions, IQVIA Solutions Italy S.r.l., Milan, Italy.
Ther Clin Risk Manag. 2021 Apr 21;17:345-356. doi: 10.2147/TCRM.S301005. eCollection 2021.
Understand the demographics and clinical features of patients with osteoarthritis (OA), quantify healthcare resource utilization by OA patients, and estimate the annual direct medical costs per OA patient from a National Health Service (NHS) perspective in Italy.
Retrospective observational cohort analysis using data from electronic medical records captured by the Italian IQVIA Longitudinal Patient Database (LPD). Only direct medical costs reimbursed by the NHS were considered. Patients were included if they received at least one diagnosis of OA during the period from January 1 to December 31, 2018. Each patient was observed for 3 years: a 24-month baseline period preceding the index date, and a 12-month follow-up period starting at the index date.
A total of 71,467 patients met inclusion criteria: 43.98% had not been prescribed NSAIDs/opioids, 40.76% had been prescribed NSAIDs, and 15.26% an opioid. Mean age was 71.36 years, and 68.2% of the patients were women. At least one comorbidity was present in 91.34% of the patients; 38.05% were newly diagnosed with OA. During 1-year of follow-up, 173,884 prescriptions with an associated diagnosis of OA were found: 47.36% had been prescribed an NSAID, 9.11% diclofenac, 8.30% codeine+paracetamol, and 7.32% ketoprofen. Nearly 15% of the patients had at least 1 request for a specialist visit and 23.82% had at least 1 request for exams. Orthopedic visits accounted for 60% of all specialist visits. Yearly mean costs per patient were €622, for approximately €2.5 billion per year in direct costs, considering 3.9 million patients with OA in Italy. Protheses were a major driver in annual costs: €143.45 in patients without a prosthesis and €10,090.91 in those with a joint prosthesis.
This real-world analysis of direct costs of care of patients with OA in Italy confirms the substantial economic burden. Direct costs dramatically increased when joint replacement was needed.
了解骨关节炎（OA）患者的人口统计学特征和临床特征，量化OA患者的医疗资源利用情况，并从意大利国家医疗服务体系（NHS）的角度估算每位OA患者的年度直接医疗费用。
使用意大利艾昆纬纵向患者数据库（LPD）捕获的电子病历数据进行回顾性观察队列分析。仅考虑由NHS报销的直接医疗费用。纳入2018年1月1日至12月31日期间至少被诊断为OA一次的患者。对每位患者进行3年观察：索引日期前24个月的基线期，以及从索引日期开始的12个月随访期。
共有71467名患者符合纳入标准：43.98%未开具非甾体抗炎药/阿片类药物，40.76%开具了非甾体抗炎药，15.26%开具了阿片类药物。平均年龄为71.36岁，68.2%的患者为女性。91.34%的患者至少有一种合并症；38.05%为新诊断的OA患者。在1年的随访期间，发现173884张与OA诊断相关的处方：47.36%开具了非甾体抗炎药，9.11%开具了双氯芬酸,8.30%开具了可待因+对乙酰氨基酚，7.32%开具了酮洛芬。近15%的患者至少有1次专科就诊请求，23.82%的患者至少有1次检查请求。骨科就诊占所有专科就诊的60%。每位患者的年平均费用为622欧元，考虑到意大利有390万OA患者，每年的直接费用约为25亿欧元。假体是年度费用的主要驱动因素：无假体患者为143.45欧元，有关节假体患者为10090.91欧元。
这项对意大利OA患者护理直接成本的真实世界分析证实了巨大的经济负担。当需要进行关节置换时，直接成本会大幅增加。
