Franklin Pharmaceutical Consulting, Cary, NC, USA.
PRECISIONheor, Boston, MA, USA.
J Med Econ. 2024 Jan-Dec;27(1):671-677. doi: 10.1080/13696998.2024.2340382. Epub 2024 Apr 27.
Non-cystic fibrosis bronchiectasis (NCFB) is a chronic progressive respiratory disorder occurring at a rate ranging from 4.2 to 278.1 cases per 100,000 persons, depending on age, in the United States. For many patients with NCFB, the presence of (PA) makes treatment more complicated and typically has worse outcomes. Management of NCFB can be challenging, warranting a better understanding of the burden of illness for NCFB, treatments applied, healthcare resources used, and subsequent treatment costs. Comparing patients diagnosed with exacerbated NCFB, with or without PA on antibiotic utilization, treatments, and healthcare resources utilization and costs was the purpose of this study.
This was a retrospective cohort study of commercial claims from IQVIA's PharMetrics Plus database (January 1,2006-December 31, 2020). Study patients with a diagnosis of NCFB were stratified into two groups based on the presence or absence of PA, then followed to identify demographic characteristics, comorbid conditions, antibiotic treatment regimen prescribed, healthcare resources utilized, and costs of care.
The results showed that patients with exacerbated NCFB who were PA had significantly more oral antibiotic fills per patient per year, more inpatient admissions with a longer length of stay, and more outpatient encounters than those who were PA. For costs, PA patients also had significantly greater total healthcare costs per patient when compared to those who were PA.
Exacerbated NCFB with PA was associated with increased antibiotic usage, greater resource utilization, and increased costs. The major contributor to the cost differences was the use of inpatient services. Treatment strategies aimed at reducing the need for inpatient treatment could lessen the disparities observed in patients with NCFB.
非囊性纤维化支气管扩张症（NCFB）是一种慢性进行性呼吸系统疾病，其在美国的发病率范围为每 100,000 人 4.2 至 278.1 例，具体取决于年龄。对于许多 NCFB 患者，存在铜绿假单胞菌（PA）会使治疗更加复杂，且通常预后更差。NCFB 的管理具有挑战性，需要更好地了解 NCFB 的疾病负担、应用的治疗方法、使用的医疗资源以及随后的治疗成本。本研究旨在比较诊断为恶化 NCFB 且存在或不存在 PA 的患者在抗生素使用、治疗和医疗资源使用和成本方面的差异。
这是一项回顾性队列研究，涉及 IQVIA 的 PharMetrics Plus 数据库中的商业索赔数据（2006 年 1 月 1 日至 2020 年 12 月 31 日）。根据是否存在 PA，将患有 NCFB 的研究患者分为两组，然后进行随访以确定人口统计学特征、合并症、处方的抗生素治疗方案、使用的医疗资源以及护理成本。
结果显示，与不存在 PA 的患者相比，存在 PA 的恶化 NCFB 患者的每位患者每年口服抗生素用量更多，住院次数更多且住院时间更长，门诊就诊次数也更多。在成本方面，与不存在 PA 的患者相比，存在 PA 的患者的每位患者的总医疗费用也显著更高。
存在 PA 的恶化 NCFB 与抗生素使用增加、资源利用增加和成本增加有关。造成成本差异的主要原因是住院服务的使用。旨在减少住院治疗需求的治疗策略可能会减少 NCFB 患者中观察到的差异。
