Department of Medicine, Lillebaelt Hospital, Vejle, Denmark.
Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
Adv Ther. 2023 Dec;40(12):5502-5518. doi: 10.1007/s12325-023-02701-z. Epub 2023 Oct 14.
Progression of fibrosis in interstitial lung diseases (ILD) has been associated with poor prognosis, lower quality of life for patients and caregivers, and higher healthcare costs. This study estimated the burden of disease and productivity loss of progressively fibrosing ILD, focusing on progressive pulmonary fibrosis other than idiopathic pulmonary fibrosis (non-IPF PPF) and systemic sclerosis-associated ILD (SSc-ILD) in the European Economic Area (EEA).
An economic model was built to estimate the clinical burden of SSc-ILD and non-IPF PPF. The model was based on published data on disease prevalence and disease burden (in terms of comorbidities, exacerbations, and deaths) as well as on productivity loss (in terms of sick days, early retirement, permanent disability, and job loss). Aggregate income loss was obtained by multiplying productivity loss by the median daily income in each country/area of investigation. A sensitivity analysis was performed to test the impact of the variability of the model assumptions.
In the whole EEA, a total of 86,794 and 13,221 individuals were estimated to be affected by non-IPF PPF and SSc-ILD, respectively. Estimated annual sick days associated with the diseases were 3,952,604 and 672,172, early retirements were 23,174 and 5341, permanently disabled patients were 41,748 and 4037, and job losses were 19,789 and 2617 for non-IPF PPF and SSc-ILD, respectively. Annual exacerbations were estimated to be 22,401-31,181 and 1259-1753, while deaths were 5791-6171 and 572-638 in non-IPF PPF and SSc-ILD, respectively. The estimated annual aggregate income loss in EEA, accounting for losses due to annual sick days, early retirements, and permanently disabled patients, was €1433 million and €220 million in non-IPF PPF and SSc-ILD, respectively. The productivity loss due to job losses was €194 million and €26 million in non-IPF PPF and SSc-ILD, respectively. The main driver of aggregate income loss variability was the prevalence.
The impact of non-IPF PPF and SSc-ILD on society is definitely non-negligible. Actions to reduce the burden on our societies are highly needed.
间质肺疾病（ILD）的纤维化进展与不良预后、患者和照护者生活质量下降以及医疗保健成本增加有关。本研究旨在评估欧洲经济区（EEA）进行性纤维化ILD（主要为特发性肺纤维化以外的进展性肺纤维化和系统性硬化症相关ILD）的疾病负担和生产力损失。
构建经济模型，以评估系统性硬化症相关ILD 和非特发性肺纤维化进展性纤维化的疾病负担。该模型基于疾病流行率和疾病负担（包括合并症、加重和死亡）以及生产力损失（病假、提前退休、永久残疾和失业）方面的已发表数据。通过将生产力损失乘以每个国家/地区的中位数日收入，计算出总收入损失。进行敏感性分析以测试模型假设的可变性的影响。
在整个 EEA 中，预计非特发性肺纤维化进展性纤维化和系统性硬化症相关ILD 的患者人数分别为 86794 人和 13221 人。估计与这些疾病相关的年病假分别为 3952604 天和 672172 天，提前退休人数分别为 23174 人和 5341 人，永久性残疾患者人数分别为 41748 人和 4037 人，失业人数分别为 19789 人和 2617 人。非特发性肺纤维化进展性纤维化和系统性硬化症相关ILD 的年加重事件估计分别为 22401-31181 次和 1259-1753 次，而死亡人数分别为 5791-6171 人和 572-638 人。非特发性肺纤维化进展性纤维化和系统性硬化症相关ILD 在 EEA 的年总收入损失（包括因年病假、提前退休和永久性残疾患者造成的损失）分别为 1.433 亿欧元和 2.200 亿欧元。非特发性肺纤维化进展性纤维化和系统性硬化症相关ILD 的失业造成的生产力损失分别为 1.940 亿欧元和 2.600 亿欧元。总收入损失可变性的主要驱动因素是流行率。
非特发性肺纤维化进展性纤维化和系统性硬化症相关ILD 对社会的影响肯定不可忽视。急需采取行动减轻我们社会的负担。
