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大疱性类天疱疮患者的特征、治疗模式、医疗资源利用及费用:美国医疗保险理赔数据的回顾性分析

Characteristics, treatment patterns, health care resource utilization and costs in patients with bullous pemphigoid: A retrospective analysis of US health insurance claims data.

作者信息

Stirnadel-Farrant Heide A, Xu Xiao, Kwiatek Justin, Jain Priya, Meyers Juliana, Candrilli Sean, Mines Daniel, Datto Catherine J

机构信息

BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK.

BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Maryland.

出版信息

JAAD Int. 2023 Jun 9;13:117-125. doi: 10.1016/j.jdin.2023.04.014. eCollection 2023 Dec.

Abstract

BACKGROUND

Real-world data describing the impact of incident bullous pemphigoid (BP) on patients and health care resource utilization (HCRU) are limited.

OBJECTIVE

To examine characteristics, treatment patterns, HCRU, and costs for incident BP.

METHODS

Retrospective analysis of 2015 to 2019 US health insurance claims for patients ≥18 years with an incident BP diagnosis. Patients with BP were matched to those without on demographic and clinical characteristics. Statistics were descriptive.

RESULTS

The mean Charlson Comorbidity Index score was higher for patients with BP ( = 1108) than without ( = 4621) at baseline (mean [SD]: 3.3 [2.7] vs 2.8 [2.4]) and during follow-up (5.0 [4.9] vs 3.7 [3.0]). Hypertension, diabetes, skin ulcers, chronic pulmonary disease, dyslipidemia, sleep disorders, and congestive heart failure were higher with BP. Most patients with BP received antibiotics (>80%) and/or corticosteroids (>90%). Hospitalizations were more common (44.0% vs 17.1%) and monthly all-cause health care costs more than double ($3214 vs $1353) in patients with BP than without.

LIMITATIONS

Diagnoses were based on billing codes. HCRU claims data may not reflect the true number of encounters.

CONCLUSION

Incident BP is associated with considerable morbidity, HCRU, and costs. More effective, targeted treatments are needed to improve quality of life, while minimizing exposure to systemic corticosteroids.

摘要

背景

描述新发大疱性类天疱疮(BP)对患者及医疗资源利用(HCRU)影响的真实世界数据有限。

目的

研究新发BP的特征、治疗模式、HCRU及成本。

方法

对2015年至2019年美国≥18岁新发BP诊断患者的医疗保险理赔数据进行回顾性分析。将BP患者与非BP患者按人口统计学和临床特征进行匹配。统计为描述性统计。

结果

BP患者的平均Charlson合并症指数评分在基线时(均值[标准差]:3.3[2.7]对2.8[2.4])及随访期间(5.0[4.9]对3.7[3.0])均高于非BP患者(分别为1108例和4621例)。BP患者的高血压、糖尿病、皮肤溃疡、慢性肺病、血脂异常、睡眠障碍和充血性心力衰竭发生率更高。大多数BP患者接受了抗生素(>80%)和/或皮质类固醇(>90%)治疗。BP患者的住院更常见(44.0%对17.1%),每月全因医疗费用是非BP患者的两倍多(3214美元对1353美元)。

局限性

诊断基于计费代码。HCRU理赔数据可能无法反映实际就诊次数。

结论

新发BP与相当高的发病率、HCRU及成本相关。需要更有效、有针对性的治疗来改善生活质量,同时尽量减少全身皮质类固醇的暴露。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67f1/10550796/753587b3e520/gr1.jpg

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