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西班牙中重度斑块状银屑病患者 PASI90 或 PASI100 应答的社会价值。

The social value of a PASI 90 or PASI 100 response in patients with moderate-to-severe plaque psoriasis in Spain.

机构信息

Department of Health Outcomes Research, Weber, Madrid, Spain.

Department of Management, Psoriasis and Psoriatic Arthritis Patient and Family Association (Acción Psoriasis), Barcelona, Spain.

出版信息

Front Public Health. 2023 Jan 26;11:1000776. doi: 10.3389/fpubh.2023.1000776. eCollection 2023.


DOI:10.3389/fpubh.2023.1000776
PMID:36778548
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9909187/
Abstract

INTRODUCTION: Psoriasis is a chronic disease involving the skin, which significantly impacts the quality of life. Disease severity and treatment efficacy (i.e., response) are assessed through the Psoriasis Area and Severity Index (PASI). A PASI 75 response, i.e., an improvement of at least 75% with respect to the baseline PASI score, has traditionally been used as a therapeutic benchmark in clinical trials. Therapeutic advances have made PASI 90 or PASI 100 responses possible in most patients treated with some biologics. A greater response may generate social value beyond clinical outcomes that would benefit both patients and society. METHODS: A 1-year economic model was applied to estimate the impact of having a PASI 75, PASI 90, or PASI 100 response in four areas of analysis (quality of life, activities of daily living, work productivity, and out-of-pocket expenditures) and the social value of having a PASI 90 or PASI 100 response in comparison with a PASI 75 response. A mixed-methods approach based on the scientific literature, a focus group with patient, and an advisory committee with psoriasis stakeholders was used. The model included three different scenarios: having a PASI 90 vs a PASI 75 response; a PASI 100 vs a PASI 90 response; and a PASI 100 vs a PASI 75 response. A sensitivity analysis was included. RESULTS: The annual economic impact per patient with moderate-to-severe plaque psoriasis having a PASI 75 response was estimated at Ł 6,139, mainly related to labour productivity losses and quality of life reductions. Having a PASI 90 or a PASI 100 response would reduce this impact to €3,956 or €1,353, respectively. Accordingly, the social value of having a PASI 90 instead of a PASI 75 response was estimated at €2,183, and €4,786 with a PASI 100 response. DISCUSSION: A PASI 90 or PASI 100 response would have a lower economic impact and a greater social value than a PASI 75 response for patients with moderate-to-severe plaque psoriasis.

摘要

引言:银屑病是一种涉及皮肤的慢性疾病,会显著影响生活质量。疾病严重程度和治疗效果(即反应)通过银屑病面积和严重程度指数(PASI)进行评估。传统上,PASI75 反应(即与基线 PASI 评分相比至少改善 75%)被用作临床试验中的治疗基准。随着治疗的进步,大多数接受某些生物制剂治疗的患者都有可能实现 PASI90 或 PASI100 反应。更大的反应可能会产生超出临床结果的社会效益,使患者和社会受益。

方法:应用了一种为期 1 年的经济模型,以评估在四个分析领域(生活质量、日常生活活动、工作生产力和自付支出)中达到 PASI75、PASI90 或 PASI100 反应的影响,以及与 PASI75 反应相比,达到 PASI90 或 PASI100 反应的社会效益。采用了一种基于科学文献、患者焦点小组和银屑病利益相关者咨询委员会的混合方法。该模型包括三种不同的情况:PASI90 与 PASI75 反应的比较;PASI100 与 PASI90 反应的比较;PASI100 与 PASI75 反应的比较。进行了敏感性分析。

结果:患有中度至重度斑块型银屑病且达到 PASI75 反应的患者,每年的经济影响估计为 6139 英镑,主要与劳动生产力损失和生活质量降低有关。达到 PASI90 或 PASI100 反应会将这种影响分别降低到 3956 欧元或 1353 欧元。因此,与 PASI75 反应相比,达到 PASI90 反应的社会效益估计为 2183 欧元,达到 PASI100 反应的社会效益估计为 4786 欧元。

讨论:与 PASI75 反应相比,患有中度至重度斑块型银屑病的患者达到 PASI90 或 PASI100 反应的经济影响较低,社会效益更大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4dc/9909187/db0b026d9c75/fpubh-11-1000776-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4dc/9909187/c33899ca42bd/fpubh-11-1000776-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4dc/9909187/f8c1e985f55c/fpubh-11-1000776-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4dc/9909187/db0b026d9c75/fpubh-11-1000776-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4dc/9909187/c33899ca42bd/fpubh-11-1000776-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4dc/9909187/f8c1e985f55c/fpubh-11-1000776-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4dc/9909187/db0b026d9c75/fpubh-11-1000776-g0003.jpg

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