Healthcare resource utilisation and economic burden of patients with adequate and inadequate responses to biological and targeted synthetic disease-modifying antirheumatic drugs for rheumatoid arthritis in Japan.
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引用次数: 0
Abstract
Objective: To compare healthcare resource utilisation (HCRU) and direct costs between responders versus non-responders to advanced therapies for rheumatoid arthritis (RA).
Methods: Patients initiating ≥1 advanced therapy (October 2018 - September 2019) with ≥1 RA claim (6-month pre-index period), ≥2 RA claims (any period), and ≥12 months follow-up were identified from the Medical Data Vision claims database. HCRU and all-cause and RA-related costs [direct medical, emergency department (ED), laboratory, and pharmacy] were compared between responders and non-responders. Adjusted incidence rate ratios (IRRs) for HCRU or cost were calculated via multivariable analyses.
Results: Among 2446 patients [non-responders (n = 1817); responders (n = 629)], non-responders had significantly longer hospitalisation days [IRR: 1.8 (95% CI: 1.2 - 2.6)], and significantly more ED visits [2.5 (1.5 - 4.2)] and prescriptions [1.1 (1.1 - 1.2)]. Mean all-cause hospital/outpatient medical costs were significantly higher for non-responders [1.4 (1.3 - 1.6), ¥530,895 versus ¥357,009 ($3992 versus $2684) for responders; ¥173,886 ($1307) difference]; RA-related medical costs showed a similar trend [¥351,306 vs ¥253,030 ($2641 vs $1902); ¥98,276 ($739) difference]. No differences between responders and non-responders were observed in mean all-cause and RA-related pharmacy costs.
Conclusions: Non-responders to advanced therapies had greater HCRU and all-cause/RA-related direct costs as compared with responders, suggesting a need for more effective RA therapies to reduce the economic burden associated with non-response.
目的：比较类风湿性关节炎（RA）高级治疗有应答者和无应答者的医疗资源利用率（HCRU）和直接成本，从Medical Data Vision索赔数据库中确定了≥12个月的随访。在应答者和非应答者之间比较HCRU和全因及RA相关费用（直接医疗、急诊科[ED]、实验室和药房）。通过多变量分析计算HCRU或成本的调整后发病率比率（IRRs）。结果：在2446名患者中（无应答者[n=1817]；应答者[n=629]），无应答者的住院天数显著延长（IRR:1.8[95%CI:1.2-2.6]），急诊就诊次数（2.5[1.5-4.2]）和处方次数（1.1[1.1-1.2]）显著增加。无应答者的平均全因医院/门诊医疗费用显著增加（应答者1.4[1.3-1.6]，530895日元vs 357009日元[美元；3992日元vs美元；2684]；173886[美元；1307]差异）；RA相关的医疗费用也呈现出类似的趋势（351306日元对253030日元【2641美元对1902美元】；98276日元【739美元】的差异）。有应答者和无应答者在平均全因和RA相关的药房费用方面没有观察到差异。结论：与有应答者相比，对高级治疗无应答者的HCRU和全因/RA相关的直接成本更高，这表明需要更有效的RA治疗来减轻与无应答相关的经济负担。
期刊介绍：
Modern Rheumatology publishes original papers in English on research pertinent to rheumatology and associated areas such as pathology, physiology, clinical immunology, microbiology, biochemistry, experimental animal models, pharmacology, and orthopedic surgery.
Occasional reviews of topics which may be of wide interest to the readership will be accepted. In addition, concise papers of special scientific importance that represent definitive and original studies will be considered.
Modern Rheumatology is currently indexed in Science Citation Index Expanded (SciSearch), Journal Citation Reports/Science Edition, PubMed/Medline, SCOPUS, EMBASE, Chemical Abstracts Service (CAS), Google Scholar, EBSCO, CSA, Academic OneFile, Current Abstracts, Elsevier Biobase, Gale, Health Reference Center Academic, OCLC, SCImago, Summon by Serial Solutions
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