Research Department, Sorlandet Hospital, Kristiansand, Norway.
Department of Rheumatology, Martina Hansens Hospital, Bærum, Oslo, Norway.
BMC Health Serv Res. 2022 Jan 10;22(1):48. doi: 10.1186/s12913-021-07425-w.
In Norway, an annual tender system for the prescription of biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) has been used since 2007. This study aimed to explore annual b/tsDMARDs costs and disease outcomes in Norwegian rheumatoid arthritis (RA) patients between 2010 and 2019 under the influence of the tender system.
RA patients monitored in ordinary clinical practice were recruited from 10 Norwegian centers. Data files from each center for each year were collected to explore demographics, disease outcomes, and the prescribed treatment. The cost of b/tsDMARDs was calculated based on the drug price given in the annual tender process.
The number of registered RA patients increased from 4909 in 2010 to 9335 in 2019. The percentage of patients receiving a b/tsDMARD was 39% in 2010 and 45% in 2019. The proportion of b/tsDMARDs treated patients achieving DAS28 remission increased from 42 to 67%. The estimated mean annual cost to treat a patient on b/tsDMARDs fell by 47%, from 13.1 thousand euros (EUR) in 2010 to 6.9 thousand EUR in 2019. The mean annual cost to treat b/tsDMARDs naïve patients was reduced by 75% (13.0 thousand EUR in 2010 and 3.2 thousand EUR in 2019).
In the period 2010-2019, b/tsDMARD treatment costs for Norwegian RA patients were significantly reduced, whereas DAS28 remission rates increased. Our data may indicate that the health authorities' intention to reduce treatment costs by implementing a tender system has been successful.
自 2007 年以来，挪威一直采用年度招标制度来开处生物制剂和靶向合成的疾病修正抗风湿药物（b/tsDMARDs）。本研究旨在探讨 2010 年至 2019 年期间，在招标制度的影响下，挪威类风湿关节炎（RA）患者的年度 b/tsDMARDs 费用和疾病结局。
从 10 个挪威中心招募了接受常规临床实践监测的 RA 患者。收集每个中心每年的数据文件，以探讨人口统计学特征、疾病结局和所开处方的治疗。b/tsDMARDs 的费用是根据年度招标过程中给出的药物价格计算的。
登记的 RA 患者人数从 2010 年的 4909 人增加到 2019 年的 9335 人。2010 年接受 b/tsDMARD 治疗的患者比例为 39%，2019 年为 45%。接受 b/tsDMARD 治疗的患者达到 DAS28 缓解的比例从 42%增加到 67%。治疗 b/tsDMARDs 患者的估计年平均费用下降了 47%，从 2010 年的 13.1 万欧元（EUR）降至 2019 年的 6.9 万 EUR。治疗 b/tsDMARDs 初治患者的年平均费用下降了 75%（2010 年为 13.0 万 EUR，2019 年为 3.2 万 EUR）。
在 2010 年至 2019 年期间，挪威 RA 患者的 b/tsDMARD 治疗费用显著降低，而 DAS28 缓解率有所提高。我们的数据可能表明，卫生当局通过实施招标制度来降低治疗费用的意图已经成功。
