美国类风湿关节炎患者使用生物制剂类改善病情抗风湿药物的经济负担。

The economic burden of biologic disease-modifying antirheumatic drugs in rheumatoid arthritis patients in the United States.

机构信息

Department of Pharmaceutical Sciences, Ferris State University College of Pharmacy, Big Rapids, MI, USA.

Department of Pharmacy Practice, Ferris State University College of Pharmacy, Grand Rapids, MI, USA.

出版信息

Expert Rev Pharmacoecon Outcomes Res. 2022 Dec;22(8):1231-1241. doi: 10.1080/14737167.2022.2117690. Epub 2022 Sep 6.

DOI:10.1080/14737167.2022.2117690

PMID:36004551

Abstract

BACKGROUND

Previous U.S. economic burden estimates for rheumatoid arthritis (RA) varied from $85.6 to $148.1 billion annually. However, these estimates do not reflect comparative amounts spent on RA treatment options in addition to other medical expenditures. Therefore, this study's goal was to comparatively analyze the overall economic burden of U.S. patients treated for RA using conventional disease-modifying antirheumatic drugs (DMARDs) versus TNF alpha biologic DMARDs.

RESEARCH DESIGN AND METHODS

This retrospective observational study analyzed Medical Expenditure Panel Survey Household Component data from 2016 to 2018. Healthcare utilization, total medical expenditures, and out-of-pocket expenditures were compared between RA medication groups.

RESULTS

Three hundred twenty-five adult RA patients experiencing 603 RA-related events, including at least one medical visit, were identified. Rheumatic arthritis-attributable medical expenditures among patients prescribed DMARDs were $11.4 billion. Average total medical expenditures were significantly higher for the TNF alpha biologic group $26,216.67 (95% CI: $19,502.84-$32,930.5) versus $5,388.52 (95% CI: $2,768.25-$8,008.79) for the conventional DMARD group (p < 0.001).

CONCLUSIONS

RA patients receiving TNF alpha biologics experienced significantly higher total medical and out-of-pocket expenditures; however, they experienced fewer or no occurrences of high-cost drivers of healthcare utilization compared to patients receiving conventional DMARDs.

摘要

背景

先前美国对类风湿关节炎（RA）的经济负担估计值在每年 856 亿至 1481 亿美元之间不等。然而，这些估计并未反映出除其他医疗支出外，RA 治疗方案的相对支出。因此，本研究旨在比较分析使用传统疾病修饰抗风湿药物（DMARDs）与 TNF 拮抗剂生物 DMARDs 治疗 RA 的美国患者的总体经济负担。

研究设计与方法

本回顾性观察性研究分析了 2016 年至 2018 年医疗保险和医疗补助服务中心调查家庭部分的数据。比较了 RA 药物组之间的医疗保健利用、总医疗支出和自付支出。

结果

共确定了 325 名患有 603 次 RA 相关事件（至少一次就诊）的成年 RA 患者。处方 DMARDs 的患者的 RA 相关医疗支出为 114 亿美元。TNF 拮抗剂生物 DMARD 组的平均总医疗支出明显更高，为 26216.67 美元（95%CI：19502.84-32930.5），而传统 DMARD 组为 5388.52 美元（95%CI：2768.25-8008.79）（p<0.001）。