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匈牙利乳糜泻成年患者的健康效用和支付意愿。

Health utilities and willingness to pay in adult patients with coeliac disease in Hungary.

机构信息

Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, 26 Üllői út, Budapest, 1085, Hungary.

Department of Health Policy, Corvinus University of Budapest, 8 Fővám tér, Budapest, 1093, Hungary.

出版信息

Qual Life Res. 2023 Sep;32(9):2503-2516. doi: 10.1007/s11136-023-03418-w. Epub 2023 Apr 17.

Abstract

BACKGROUND

Coeliac disease (CD) is a life-long food-related disorder with a global prevalence of approximately 1%. Patients with CD often experience reduced health-related quality of life that could improve with a strict adherence to a gluten-free diet (GFD).

OBJECTIVES

To obtain visual analogue scale (VAS), time trade-off (TTO) and willingness-to-pay (WTP) values amongst patients with CD.

METHODS

In 2020-2021, a cross-sectional online survey was conducted amongst 312 adult CD patients in Hungary. Patients completed the Gastrointestinal Symptom Rating Scale (GSRS) and evaluated their current health and three hypothetical health state vignettes defined based on dietary adherence using VAS, conventional 10-year TTO and WTP. Multivariate regressions were used to explore the effect of patients' demographic and clinical characteristics on utility and WTP values.

RESULTS

Mean VAS values for current health and 'CD with strict adherence to GFD', 'CD with loose adherence to GFD' and 'CD without GFD' hypothetical health states were 79.69 ± 18.52, 85.36 ± 16.18, 62.44 ± 19.91 and 36.69 ± 25.83, respectively. Corresponding mean TTO utilities were: 0.90 ± 0.19, 0.91 ± 0.20, 0.87 ± 0.23 and 0.76 ± 0.29. Mean annual WTP values for returning to full health were: €845 ± 1077, €648 ± 1002, €862 ± 1135 and €1251 ± 1496. Older age at diagnosis, male sex, more severe gastrointestinal symptoms (GSRS) and having comorbidities were associated with lower VAS and TTO or higher WTP values for current own health (p < 0.05).

CONCLUSION

This is the first study to report TTO utilities for CD health states. Strict adherence to the GFD may result in substantial health gains in symptomatic patients. Utilities and WTP results can be used to estimate benefits of GFD in cost-utility and cost-benefit analyses.

摘要

背景

乳糜泻(CD)是一种终生与食物相关的疾病,全球患病率约为 1%。CD 患者常经历生活质量下降,如果严格遵循无麸质饮食(GFD),则可能改善生活质量。

目的

获得 CD 患者的视觉模拟量表(VAS)、时间权衡(TTO)和支付意愿(WTP)值。

方法

2020-2021 年,在匈牙利对 312 名成年 CD 患者进行了横断面在线调查。患者完成了胃肠道症状评分量表(GSRS),并使用 VAS、常规 10 年 TTO 和 WTP 对当前健康状况和三种基于饮食依从性定义的假设健康状态 vignettes 进行了评估。多变量回归用于探索患者的人口统计学和临床特征对效用和 WTP 值的影响。

结果

当前健康状况和“严格遵循 GFD 的 CD”、“ loosely 遵循 GFD 的 CD”和“不遵循 GFD 的 CD”假设健康状态的 VAS 平均值分别为 79.69±18.52、85.36±16.18、62.44±19.91 和 36.69±25.83。相应的平均 TTO 效用分别为:0.90±0.19、0.91±0.20、0.87±0.23 和 0.76±0.29。恢复到完全健康的年平均 WTP 值分别为:845±1077、648±1002、862±1135 和 1251±1496。诊断时年龄较大、男性、胃肠道症状(GSRS)更严重和合并症与当前自身健康的 VAS 和 TTO 较低或 WTP 较高相关(p<0.05)。

结论

这是第一项报告 CD 健康状况 TTO 效用的研究。严格遵循 GFD 可能会使有症状的患者获得显著的健康收益。效用和 WTP 结果可用于估计 GFD 在成本效用和成本效益分析中的获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9db/10393904/87b0195ba63f/11136_2023_3418_Fig1_HTML.jpg

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