Perera Sue, Ma Liyuan, Punwaney Raj, Ramachandran Sulabha
GSK, Uxbridge, London, UK.
GSK, Pennsylvania, PA, USA.
J Health Econ Outcomes Res. 2018 Feb 22;5(2):150-161. doi: 10.36469/9807. eCollection 2018.
Current knowledge of the disease burden of primary Sjögren's syndrome (pSS) is limited. The primary objective of this study was to describe the demographic and clinical characteristics of patients with pSS. The secondary objective was to describe the treatment patterns and healthcare resource utilization of patients with pSS. Furthermore, clinical characteristics of interest were described and the proportions of patients with glandular versus extra-glandular disease were reported. This was a retrospective cohort study (HO-15-16077) conducted in the US Truven MarketScan Commercial database. We report descriptive data from employees and their families, as covered by employer-sponsored medical insurance. The primary cohort comprised patients with pSS (with ≥1 diagnosis of sicca syndrome prior to January 1, 2013), with continuous enrollment for ≥24 months (January 1, 2012-December 31, 2013). Patients with conditions mimicking sicca symptoms not due to SS were excluded, as were those with connective tissue disease that may have suggested secondary SS. To compare the healthcare burden of patients with and without sicca symptoms, a 1:1 matched comparator population comprising subjects without a previous diagnosis of sicca syndrome (sicca-free) was also identified. There were 12 717 eligible patients in the primary cohort. The majority (86%) was female and the mean age was 51 years. Overall, 60.7% of patients had claims associated with pSS extra glandular disease manifestations. These patients experienced a higher disease burden, and more commonly reported pain, fatigue or insomnia and any combination of pain, fatigue or insomnia (41.3%) compared with patients with glandular disease only (12.4%). Patients in the primary cohort incurred greater annual healthcare service costs (1.6 times greater, all causes) and healthcare resource utilization compared with the sicca-free comparator cohort. Patients with extra glandular disease also incurred greater average annual costs (2.9 times) contributing to ≥2 times/year more resource use for outpatient services than patients with glandular disease only. Patients with pSS experience a high disease burden despite treatment. This study provides novel insights in to the extent of the burden on healthcare resources among patients with pSS, in particular for patients with extra-glandular disease manifestations, when compared with sicca-free subjects.
目前对原发性干燥综合征（pSS）疾病负担的了解有限。本研究的主要目的是描述pSS患者的人口统计学和临床特征。次要目的是描述pSS患者的治疗模式和医疗资源利用情况。此外，还描述了感兴趣的临床特征，并报告了腺体疾病与腺外疾病患者的比例。这是一项在美国Truven MarketScan商业数据库中进行的回顾性队列研究（HO-15-16077）。我们报告了雇主赞助医疗保险覆盖的员工及其家属的描述性数据。主要队列包括pSS患者（在2013年1月1日前至少有1次干燥综合征诊断），连续入组≥24个月（2012年1月1日至2013年12月31日）。排除了因非SS导致的类似干燥症状的患者，以及可能提示继发性SS的结缔组织病患者。为了比较有和没有干燥症状患者的医疗负担，还确定了一个1:1匹配的对照人群，包括以前没有干燥综合征诊断的受试者（无干燥症）。主要队列中有12717名符合条件的患者。大多数（86%）为女性，平均年龄为51岁。总体而言，60.7%的患者有与pSS腺外疾病表现相关的索赔。与仅患有腺体疾病的患者（12.4%）相比，这些患者经历了更高的疾病负担，更常报告疼痛、疲劳或失眠以及疼痛、疲劳或失眠的任何组合（41.3%）。与无干燥症对照队列相比，主要队列中的患者每年产生更高的医疗服务成本（所有原因导致的成本高1.6倍）和医疗资源利用。患有腺外疾病的患者平均每年产生的成本也更高（2.9倍），导致门诊服务的资源使用比仅患有腺体疾病的患者每年多≥2倍。尽管接受了治疗，pSS患者仍经历着较高的疾病负担。与无干燥症受试者相比，本研究为了解pSS患者的医疗资源负担程度提供了新的见解，特别是对于有腺外疾病表现的患者。
