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重症肌无力:了解捷克共和国的治疗模式及直接医疗费用。

Myasthenia gravis: understanding treatment patterns and direct medical costs in the Czech Republic.

作者信息

Donin Gleb, Mothejlová Karla, Horáková Magda, Vohanka Stanislav

机构信息

Department of Biomedical Technology, Czech Technical University in Prague, Kladno, Czech Republic.

Department of Neurology, ERN EURO-NMD Center, University Hospital Brno, Brno, Czech Republic.

出版信息

Orphanet J Rare Dis. 2024 Dec 20;19(1):472. doi: 10.1186/s13023-024-03504-3.

Abstract

BACKGROUND

Myasthenia gravis (MG) is a rare autoimmune disorder with significant clinical implications, including life-threatening myasthenic crises and exacerbations. Understanding real-world treatment patterns, especially associated direct medical costs, is essential for the effective management of healthcare delivery.

METHODS

We conducted a descriptive cohort study using health administrative claims data from the Czech Republic covering more than 1,500 prevalent MG patients. Data were analysed for healthcare resource utilization, medication costs, and hospitalization rates related to MG and its complications.

RESULTS

Acetylcholine inhibitors and corticosteroids were widely prescribed, with 91.1% and 75.2% of patients receiving them at least once, respectively. Immunosuppressive therapy was given to 45.2% of patients. Myasthenic crises occurred in 2% of patients, with a mean hospitalization cost of 21,020 EUR, while exacerbations occurred in 9.2% of patients, with lower costs (5,951 EUR per hospitalization). Outpatient intravenous immunoglobulin and plasma exchange therapies incurred additional costs of 20,700 EUR and 18,206 EUR per person-year, respectively. The mean total cost per patient-year was 1,271 EUR, with significant cost differences among patients with different treatment patterns.

CONCLUSION

This study offers real-world insights into the treatment patterns and associated direct medical costs of MG in the Czech Republic. Myasthenic crises and exacerbations pose considerable cost burdens, while outpatient therapies and common pharmacotherapies are less costly. These findings are vital for healthcare planning, economic evaluation, and resource allocation, potentially leading to enhanced patient care and outcomes.

摘要

背景

重症肌无力(MG)是一种罕见的自身免疫性疾病,具有重大的临床意义,包括危及生命的重症肌无力危象和病情加重。了解实际治疗模式,尤其是相关的直接医疗费用,对于有效管理医疗服务至关重要。

方法

我们利用来自捷克共和国的卫生行政索赔数据进行了一项描述性队列研究,涵盖了1500多名MG患者。分析了与MG及其并发症相关的医疗资源利用、药物成本和住院率数据。

结果

乙酰胆碱酯酶抑制剂和皮质类固醇被广泛处方,分别有91.1%和75.2%的患者至少接受过一次治疗。45.2%的患者接受了免疫抑制治疗。2%的患者发生了重症肌无力危象,平均住院费用为21,020欧元,而9.2%的患者病情加重,费用较低(每次住院5,951欧元)。门诊静脉注射免疫球蛋白和血浆置换疗法每人每年分别产生额外费用20,700欧元和18,206欧元。每位患者每年的平均总费用为1,271欧元,不同治疗模式的患者之间存在显著的费用差异。

结论

本研究提供了关于捷克共和国MG治疗模式及相关直接医疗费用的实际见解。重症肌无力危象和病情加重带来了相当大的成本负担,而门诊治疗和常见药物治疗成本较低。这些发现对于医疗规划、经济评估和资源分配至关重要,可能会改善患者护理和治疗结果。

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