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2018 - 2021年芬兰重度未控制的T2低和非T2低哮喘的医疗资源利用情况

Healthcare Resource Utilisation of Severe Uncontrolled T2low and Non-T2low Asthma in Finland During 2018-2021.

作者信息

Persson Josefine, Aakko Juhani, Kaijala Saara, Lassenius Mariann I, Viinanen Arja, Kankaanranta Hannu, Lehtimäki Lauri

机构信息

AstraZeneca, Nordic, Mölndal, Sweden.

Medaffcon Oy, Espoo, Finland.

出版信息

J Asthma Allergy. 2024 Jul 19;17:681-691. doi: 10.2147/JAA.S455911. eCollection 2024.

Abstract

PURPOSE

Patients with asthma and low levels of type 2 inflammatory biomarkers (T2 low) have limited effective treatment options. Such biomarkers include eg blood eosinophils (b-eos) and fractional exhaled nitric oxide (FeNO). The healthcare resource utilisation (HCRU) of severe uncontrolled T2 low asthma remains unexplored. Thus, this study aimed to estimate the HCRU of T2 low and non-T2 low severe uncontrolled asthma patients using real-world data in Finland.

PATIENTS AND METHODS

Adult patients with an asthma diagnosis during baseline (2012-2017) at the pulmonary department of Turku University Hospital were included and followed during 2018-2021, or until death. Total HCRU costs and respiratory-related HCRU costs were evaluated. The main drivers for the HCRU and costs were assessed with gamma and negative binomial regression models.

RESULTS

Of the severe uncontrolled asthma patients with T2 status available, 40% (N=66) were identified with T2 low and 60% (N=103) with non-T2 low asthma. The average cumulative cost per patient was similar in patients with T2 low compared with non-T2 low, with all-cause costs cumulating in four years of follow-up to 37,524€ (95% CI: 27,160, 47,888) in T2 low compared to 34,712€ (25,484, 43,940) in non-T2 low. The corresponding average cumulative respiratory-related costs were 5178€ (3150, 7205) in T2 low compared to 5209€ (4104, 6313) in non-T2 low. Regression modelling identified no differences between the T2-status groups when assessing all-cause healthcare costs per patient-year (PPY). On the other hand, the regression modelling predicted more inpatient days PPY for severe uncontrolled patients with T2 low status compared to the patients with non-T2 low status.

CONCLUSION

Patients with uncontrolled severe T2 low asthma use equal healthcare resources as corresponding non-T2 low patients. This study brought new insights into the HCRU of severe uncontrolled asthma patients per T2 status, which has not previously been investigated.

摘要

目的

哮喘患者且2型炎症生物标志物水平较低(T2低)的有效治疗选择有限。此类生物标志物包括血液嗜酸性粒细胞(b - eos)和呼出一氧化氮分数(FeNO)等。重度未控制的T2低哮喘患者的医疗资源利用(HCRU)情况尚未得到充分研究。因此,本研究旨在利用芬兰的真实世界数据估算T2低和非T2低的重度未控制哮喘患者的HCRU。

患者与方法

纳入图尔库大学医院肺科在基线期(2012 - 2017年)诊断为哮喘的成年患者,并在2018 - 2021年期间进行随访,直至死亡。评估了总的HCRU成本和与呼吸相关的HCRU成本。使用伽马回归模型和负二项回归模型评估HCRU和成本的主要驱动因素。

结果

在可获得T2状态的重度未控制哮喘患者中,40%(N = 66)被确定为T2低,60%(N = 103)为非T2低哮喘。T2低的患者与非T2低的患者相比,每位患者的平均累积成本相似,在四年的随访中,T2低患者的全因成本累积至37,524€(95% CI:27,160, 47,888),而非T2低患者为34,712€(25,484, 43,940)。相应地,T2低患者与呼吸相关的平均累积成本为5178€(3150, 7205),非T2低患者为5209€(4104, 6313)。在评估每位患者每年的全因医疗成本(PPY)时,回归模型未发现T2状态组之间存在差异。另一方面,回归模型预测,与非T2低状态的患者相比,T2低状态的重度未控制患者每年的住院天数更多。

结论

未控制的重度T2低哮喘患者与相应的非T2低患者使用相同的医疗资源。本研究为按T2状态划分的重度未控制哮喘患者的HCRU带来了新的见解,此前尚未对此进行过研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a657/11268766/67401148b6c3/JAA-17-681-g0001.jpg

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