韩国预防性治疗偏头痛患者的疾病负担：基于人群的理赔数据库分析。

The disease burden of migraine patients receiving prophylactic treatments in Korea: a population-based claims database analysis.

机构信息

College of Pharmacy, Pusan National University, Busan, South Korea.

Department of Regulatory Science, Kyung Hee University, Seoul, South Korea.

出版信息

BMC Health Serv Res. 2022 Jul 12;22(1):902. doi: 10.1186/s12913-022-08191-z.

DOI:10.1186/s12913-022-08191-z

PMID:35821030

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9277836/

Abstract

BACKGROUND

Despite guideline recommendations, the limited benefits and failure of prophylactic treatment in patients with migraine have been reported. This study aimed to estimate the incremental burden (i.e., healthcare resource use and cost) of disease in patients who received at least one prophylactic treatment compared to those who did not.

METHODS

This study analyzed the Health Insurance Review and Assessment Service database, which covers the entire population of Korea from December 2014 to November 2019. We included adult patients with migraine (≥18 years) who had ≥1 claim with migraine diagnosis (G43) or received ≥1 prescription of triptan or ergotamine between December 2015 and November 2018. We defined two groups: (1) migraine patients who received at least one prophylactic treatment (prophylaxis group) and (2) migraine patients who never received prophylactic treatments (non-prophylaxis group). We performed propensity score matching to balance the baseline covariates between the two groups. In a matched cohort, we estimated healthcare resource use and costs in terms of outpatient visits, outpatient visits to neurologists, emergency department (ED) visits, and hospitalizations.

RESULTS

After matching, 633,709 and 633,709 patients were identified in the prophylaxis and non-prophylaxis groups, respectively. The healthcare resource utilization was significantly higher in the prophylaxis group than in the non-prophylaxis group in terms of the number of outpatient visits (2.34 vs 1.70), outpatient visits to neurologists (2.23 vs 1.61), ED visits (1.07 vs 1.05), and hospitalizations (1.12 vs 1.09) (all P < 0.05). The estimated annual costs per patient were significantly higher in the prophylaxis group than in the non-prophylaxis group for outpatient (102.37 USD vs. 62.46 USD), neurology outpatient (141.80 USD vs. 120.30 USD), and ED visits (550.51 USD vs. 234.14 USD) and hospitalization (817.01 USD vs. 645.97 USD) (all P < 0.001).

CONCLUSIONS

Migraine patients who received ≥1 prophylactic treatment had a higher burden of disease than migraine patients who received no prophylaxis. This indicates that despite migraine prophylaxis, the migraine-related disease burden remains high, and more efficient migraine prophylaxis strategies are needed.

摘要

背景

尽管有指南建议，但预防性治疗在偏头痛患者中的有限获益和失败已被报道。本研究旨在估计与未接受预防性治疗的患者相比，接受至少一种预防性治疗的患者的疾病增量负担（即医疗资源使用和成本）。

方法

本研究分析了健康保险审查和评估服务数据库，该数据库涵盖了 2014 年 12 月至 2019 年 11 月期间韩国的全部人口。我们纳入了≥18 岁的偏头痛成年患者（G43 诊断≥1 次或在 2015 年 12 月至 2018 年 11 月期间至少接受过 1 次曲坦类药物或麦角碱处方的患者）。我们定义了两组：（1）接受过至少一种预防性治疗的偏头痛患者（预防组）和（2）从未接受过预防性治疗的偏头痛患者（非预防组）。我们进行了倾向评分匹配，以平衡两组间的基线协变量。在匹配队列中，我们根据门诊就诊、神经内科门诊就诊、急诊就诊和住院治疗来估计医疗资源使用和成本。

结果

匹配后，预防组和非预防组分别有 633709 例和 633709 例患者。在门诊就诊次数（2.34 次 vs. 1.70 次）、神经内科门诊就诊次数（2.23 次 vs. 1.61 次）、急诊就诊次数（1.07 次 vs. 1.05 次）和住院次数（1.12 次 vs. 1.09 次）方面，预防组的医疗资源利用显著高于非预防组（均 P<0.05）。预防组的每位患者的年度医疗成本也显著高于非预防组，门诊（102.37 美元 vs. 62.46 美元）、神经内科门诊（141.80 美元 vs. 120.30 美元）和急诊就诊（550.51 美元 vs. 234.14 美元）和住院（817.01 美元 vs. 645.97 美元）（均 P<0.001）。