Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, The Netherlands.
Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Radboud university medical center, Nijmegen, The Netherlands.
J Neurol. 2021 Dec;268(12):4778-4788. doi: 10.1007/s00415-021-10591-w. Epub 2021 May 27.
Promising genetic therapies are being investigated in facioscapulohumeral muscular dystrophy (FSHD). However, the current cost of illness is largely unknown.
This study aimed at determining the socioeconomic burden of FSHD.
Adult patients with FSHD from the Dutch FSHD registry were invited to complete a questionnaire on medical consumption, work productivity and health-related quality of life (HR-QoL) using the EQ-5D-5L. Associated costs were calculated from a societal perspective. A generalized linear model was fitted to the data to investigate whether level of mobility was related to annual costs of illness.
172 patients with FSHD completed the questionnaire (response rate 65%). The per-patient annual direct medical costs of FSHD were estimated at €12,077, direct non-medical costs at €9179 and indirect costs at €5066, adding up to a total cost of illness of €26,322 per patient per year. The direct costs of illness were €21,256, approximately five times higher than the mean per-capita health expenditures in the Netherlands. Major cost-driving factors were formal home care and informal care. A decreased level of mobility was associated with higher direct costs of illness. HR-QoL was significantly reduced in patients with FSHD with a median health utility value of 0.63.
We show that FSHD is associated with substantial direct and indirect socioeconomic costs as well as a reduction in HR-QoL. These findings are important for health care decision makers and aids in allocation of research funds and evaluation of the cost-effectiveness of novel therapies.
在面肩肱型肌营养不良症(FSHD)中,正在研究有前途的基因疗法。然而,目前疾病的总体经济负担在很大程度上尚不清楚。
本研究旨在确定 FSHD 的社会经济负担。
从荷兰 FSHD 登记处邀请 FSHD 的成年患者使用 EQ-5D-5L 填写一份关于医疗消费、工作生产力和健康相关生活质量(HR-QoL)的问卷。从社会角度计算相关成本。使用广义线性模型分析了移动能力水平与疾病年度费用之间的关系。
172 名 FSHD 患者完成了问卷调查(应答率为 65%)。FSHD 每名患者的年直接医疗费用估计为 12077 欧元,直接非医疗费用为 9179 欧元,间接费用为 5066 欧元,每年每位患者的总疾病费用为 26322 欧元。疾病的直接费用为 21256 欧元,大约是荷兰人均卫生支出的五倍。主要的费用驱动因素是正规家庭护理和非正规护理。移动能力下降与更高的直接疾病费用相关。FSHD 患者的 HR-QoL 显著降低,中位健康效用值为 0.63。
我们表明 FSHD 与大量直接和间接社会经济成本以及 HR-QoL 下降相关。这些发现对医疗保健决策者很重要,有助于分配研究资金并评估新疗法的成本效益。