Universitätsklinikum Hamburg Eppendorf, IVDP, Hamburg, Germany.
InGef-Institut für angewandte Gesundheitsforschung Berlin, Berlin, Germany.
J Eur Acad Dermatol Venereol. 2024 Nov;38(11):2102-2109. doi: 10.1111/jdv.20071. Epub 2024 May 11.
Data from the AWARE study (A Worldwide Antihistamine-Refractory chronic urticaria patient Evaluation) illustrate a substantial disease burden in German patients with H1-antihistamine (-H1-AH)-refractory chronic spontaneous urticaria (CSU). Detrimental effects on patients' quality of life, poor disease control and impairment in the ability to work and perform other daily activities are reported. Based on these findings, this study aims to quantify the epidemiological and socio-economic burden of H1-AH-refractory CSU in Germany.
To determine the epidemiological burden of H1-AH-refractory CSU, the age- and gender-specific prevalence of CSU and the proportion of H1-AH-refractory patients in Germany anonymized data from the InGef research database have been used. In a second step, the socio-economic burden in terms of lost numbers of hours in paid and unpaid work was calculated by extrapolating the age- and gender-specific work productivity and activity impairment (WPAI) observed in AWARE to the H1-AH-refractory CSU population in Germany. Finally, productivity losses in paid and unpaid work were monetized using the human capital and the friction cost approach respectively. Moreover, socio-economic burden was calculated depending on symptom control of the patients (measured by urticaria control test [UCT]).
In Germany, over 203,000 patients (20 years or older) had H1-AH-refractory CSU in 2018. The avoided lost paid and unpaid work hours attributable to H1-AH-refractory CSU summed up to over 100 million. Overall, the socio-economic burden of H1-AH-refractory CSU in monetary terms was evaluated at € 2.2 billion and the majority of this was due to unpaid work loss. Patients with poor disease control, as indicated by UCT score < 12, were more likely to suffer from high impairment than patients with controlled disease, resulting in a higher socio-economic burden.
The results of our analyses picture the substantial socio-economic burden of H1-AH-refractory CSU and therefore the tremendous impact it has on daily lives of individuals and society overall.
AWARE 研究（全球抗组胺药难治性慢性荨麻疹患者评估）的数据表明，德国 H1 抗组胺药（H1-AH）难治性慢性自发性荨麻疹（CSU）患者的疾病负担很大。据报道，这会对患者的生活质量产生不利影响、疾病控制不佳以及工作和执行其他日常活动的能力受损。基于这些发现，本研究旨在量化德国 H1-AH 难治性 CSU 的流行病学和社会经济负担。
为了确定 H1-AH 难治性 CSU 的流行病学负担，使用了匿名的 InGef 研究数据库中的德国 CSU 的年龄和性别特异性患病率以及 H1-AH 难治性患者的比例。在第二步中，通过将 AWARE 中观察到的年龄和性别特异性工作生产力和活动障碍（WPAI）外推到德国 H1-AH 难治性 CSU 人群，计算了因失去有偿和无偿工作时间而导致的社会经济负担。最后，分别使用人力资本和摩擦成本方法将有偿和无偿工作的生产力损失货币化。此外，还根据患者的症状控制（通过荨麻疹控制测试 [UCT] 测量）计算了社会经济负担。
2018 年，德国有超过 203,000 名（20 岁及以上）H1-AH 难治性 CSU 患者。由于 H1-AH 难治性 CSU 而避免的有偿和无偿工作时间损失总计超过 1 亿小时。总体而言，H1-AH 难治性 CSU 的社会经济负担以货币计算为 22 亿欧元，其中大部分是由于无偿工作损失造成的。UCT 评分<12 的患者表明疾病控制较差，比疾病控制良好的患者更容易受到高障碍的影响，导致更高的社会经济负担。
我们分析的结果描绘了 H1-AH 难治性 CSU 的巨大社会经济负担，因此对个人和整个社会的日常生活产生了巨大影响。
