Health Economic and Value Assessment, Sanofi, Gentilly, France -
Sanofi SpA, Milan, Italy.
Ital J Dermatol Venerol. 2024 Oct;159(5):475-483. doi: 10.23736/S2784-8671.24.07970-2. Epub 2024 Sep 9.
Prurigo nodularis (PN) is a chronic, inflammatory skin disease characterized by intense itch. Little evidence exists on the burden of PN in Italy. This real-world analysis aimed to investigate the healthcare resource consumption and related direct costs of patients hospitalized for PN.
The analysis utilized the administrative databases of healthcare units that cover approximately 12 million inhabitants across Italy. Adult patients were included by ICD-9-CM=698.3 (lichen simplex chronicus; neurodermatitis circumscripta; PN) as proxy of PN diagnosis, from 01/2010 to 09/2021, and had 1 year of data availability before (baseline) and after (follow-up) hospitalization (index date). These patients were 1:2 matched by age, sex, and index date (year) to adults without such hospitalization in the baseline period (matched non-PN controls).
The analysis comprised 295 PN-hospitalized patients, matched with 590 non-PN individuals (mean age 63.2 years, 43.7% female). At baseline, patients had a greater comorbidity burden than non-PN controls, including higher prevalence of hypertension (56.6% vs. 36.6%, respectively), dyslipidemia (26.4% vs. 18.0%), diabetes (24.4% vs. 12.5%) and mental health conditions (14.9% vs. 7.8%). During 1-year follow-up, PN-hospitalized patients had significantly higher resource consumption than matched controls, in terms of mean number of prescriptions most commonly prescribed in PN patients (5.1 vs. 1.9, P<0.001), other drugs (11.7 vs. 6.5, P<0.001), all-cause hospitalization (1.4 vs. 0.1, P<0.001) and outpatient services (5.4 vs. 2.5, P<0.001). Mean annual all-cause healthcare costs for patients over 1-year follow-up were € 3847 total (€ 875 drugs, € 2652 hospitalization, € 320 outpatient services), higher than those for the matched controls, of € 711 total (P<0.001) (€ 353 drugs, € 228 hospitalization, € 130 outpatient services).
Patients hospitalized for PN had a higher comorbidity burden at baseline and greater healthcare resource consumption during 1-year follow-up compared to matched controls, with a 5.4-fold increase in all-cause healthcare costs, indicating substantial clinical burden and remaining unmet need in these patients.
结节性痒疹（PN）是一种慢性炎症性皮肤病，其特征为剧烈瘙痒。目前有关意大利 PN 负担的证据有限。本项真实世界研究旨在调查因 PN 住院患者的医疗资源消耗和相关直接医疗费用。
该分析利用了覆盖意大利约 1200 万居民的医疗单位的行政数据库。将 ICD-9-CM=698.3（单纯性慢性苔藓；局限性神经性皮炎；PN）作为 PN 诊断的替代指标纳入 2010 年 1 月至 2021 年 9 月期间因 PN 住院的成年患者，并在住院前（基线期）和住院后（随访期）有 1 年的数据可用（索引日期）。将这些患者按照年龄、性别和索引日期（年份）与基线期无此类住院的成年人（匹配的非 PN 对照）进行 1:2 匹配。
该分析纳入了 295 名因 PN 住院的患者，匹配了 590 名非 PN 个体（平均年龄 63.2 岁，43.7%为女性）。在基线期，患者的合并症负担比非 PN 对照组更重，包括高血压（分别为 56.6%和 36.6%）、血脂异常（26.4%和 18.0%）、糖尿病（24.4%和 12.5%）和心理健康状况（14.9%和 7.8%）的患病率更高。在 1 年随访期间，PN 住院患者的资源消耗明显高于匹配的对照组，具体表现在 PN 患者最常开具处方的药物数量（5.1 与 1.9，P<0.001）、其他药物（11.7 与 6.5，P<0.001）、全因住院治疗（1.4 与 0.1，P<0.001）和门诊服务（5.4 与 2.5，P<0.001）方面。在 1 年随访期间，PN 患者的平均年全因医疗费用为 3847 欧元（875 欧元药物，2652 欧元住院，320 欧元门诊），高于匹配对照组的 711 欧元（P<0.001）（353 欧元药物，228 欧元住院，130 欧元门诊）。
与匹配对照组相比，因 PN 住院的患者在基线期的合并症负担更高，在 1 年随访期间的医疗资源消耗更多，全因医疗费用增加了 5.4 倍，表明这些患者的临床负担较大，未满足的医疗需求仍然存在。
