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西班牙糖尿病性黄斑水肿患者的疾病负担研究

Burden of Disease Study of Patients with Diabetic Macular Oedema in Spain.

作者信息

Ruiz-Moreno José M, Gámez Lechuga María, Calvo Pilar, Merino María, Martín Lorenzo Teresa, Maravilla-Herrera Paulina, Gil Jiménez Beatriz, Abraldes Maximino J

机构信息

Ophtalmology Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain.

Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

出版信息

Ophthalmol Ther. 2024 Jul;13(7):1937-1953. doi: 10.1007/s40123-024-00959-2. Epub 2024 May 21.

Abstract

INTRODUCTION

Diabetic macular oedema (DMO) is a complication of diabetic retinopathy that can result in vision loss. The disease can impact different spheres of a patient's life, including physical and psychological health, work, and activities of daily living, entailing an important use of healthcare and non-healthcare resources. This study aimed to estimate the socio-economic burden of DMO in Spain.

METHODS

The burden of DMO was estimated from a societal perspective, per patient, year of treatment since diagnosis, and type of treatment. Four categories were considered: direct healthcare costs (DHC), direct non-healthcare costs (DNHC), labour productivity losses (LPL), and intangible costs (IC) associated with loss of quality of life. Average annual costs were calculated by multiplying the resources used per patient by their corresponding unit price (or financial proxy). For a more accurate estimation, differences in resource use between treatments (intravitreal anti-vascular endothelial growth factor injections of ranibizumab or aflibercept, and intravitreal dexamethasone implants) and year since diagnosis (first, second, and third year or beyond) were considered and presented separately. The reference year for costs was 2021.

RESULTS

The average annual costs of DMO in the first year of treatment after diagnosis was estimated at €18,774, €17,512, and €16,188 per patient treated with ranibizumab, aflibercept, and dexamethasone, respectively. This burden would be reduced to €15,783, €15,701, and €12,233 in the second year, and to €15,119, €15,043, and €12,790 in the third year, respectively. Diagnosis of DMO entails an additional one-off cost of €485. DHC accounted for the greatest proportion of total annual costs per patient, independent of the year, with LPL also making an important contribution to total costs.

CONCLUSIONS

The socio-economic impact of DMO on patients, the healthcare system, and society at large is substantial. The constant increase in its prevalence accentuates the need for planning and implementation of healthcare strategies to prevent vision loss and reduce the socio-economic burden of the disease.

摘要

引言

糖尿病性黄斑水肿(DMO)是糖尿病视网膜病变的一种并发症,可导致视力丧失。该疾病会影响患者生活的各个方面,包括身心健康、工作以及日常生活活动,需要大量使用医疗和非医疗资源。本研究旨在估算西班牙DMO的社会经济负担。

方法

从社会角度,按每位患者、自诊断起的治疗年份以及治疗类型估算DMO的负担。考虑了四个类别:直接医疗费用(DHC)、直接非医疗费用(DNHC)、劳动生产率损失(LPL)以及与生活质量丧失相关的无形费用(IC)。通过将每位患者使用的资源乘以其相应的单价(或财务代理)来计算年均成本。为了更准确地估算,考虑并分别呈现了不同治疗方法(玻璃体内注射雷珠单抗或阿柏西普抗血管内皮生长因子,以及玻璃体内地塞米松植入物)之间以及自诊断起的年份(第一年、第二年和第三年及以后)之间资源使用的差异。成本的参考年份为2021年。

结果

诊断后第一年,接受雷珠单抗、阿柏西普和地塞米松治疗的每位患者的DMO年均成本分别估计为18,774欧元、17,512欧元和16,188欧元。第二年,这一负担将分别降至15,783欧元、15,701欧元和12,233欧元,第三年则分别降至15,119欧元、15,043欧元和12,790欧元。DMO的诊断还需要额外一次性费用485欧元。每位患者每年总成本中,DHC占比最大,且与年份无关,LPL对总成本也有重要贡献。

结论

DMO对患者、医疗系统以及整个社会的社会经济影响巨大。其患病率不断上升,凸显了规划和实施医疗策略以预防视力丧失并减轻该疾病社会经济负担的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fe9/11178718/dd39dac7dff9/40123_2024_959_Fig1_HTML.jpg

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