嗜酸性肉芽肿合并多血管炎患者的医疗资源利用和成本：德国保险索赔数据的回顾性分析。

IF 2.9 3区医学 Q2 RHEUMATOLOGY

Rheumatology and Therapy Pub Date : 2025-10-17 DOI:10.1007/s40744-025-00795-1

Paul Dolin, Anat Shavit, Jennifer Rowell, Chris Edmonds, Josefine Persson, Danuta Kielar, Keltie McDonald, Antje Mevius, Bernhard Hellmich, Stephanie Y Chen

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引用次数: 0

摘要

欧洲嗜酸性肉芽肿病合并多血管炎（EGPA）的临床和经济负担证据有限。我们评估了德国EGPA医疗保健资源利用率（HCRU）、休息日和成本。方法：本分析使用德国法定健康保险基金AOK Plus的索赔数据。新诊断为EGPA的患者（指标日期为2016-2020年；诊断前健康计划登记≥12个月）与没有EGPA的普通参保个体（1:4）匹配。基线为诊断前12个月；随访至2020年12月31日、保险退出或死亡。结果包括HCRU、相关费用和休假天数。结果：研究纳入155例患者和620例匹配个体。在EGPA队列中，所有类别的全因HCRU在诊断后均高于基线。在诊断后1年内，任何EGPA治疗的平均年住院率/患者和药房索赔率/患者分别为2.99和5.87，而基线期间分别为1.15和1.80。诊断后1年内，全因HCRU/ EGPA患者的年平均总成本为19,700欧元，而基线期为6,678欧元，其中住院和药房费用是EGPA护理的主要成本驱动因素。诊断后5年多，在所有HCRU评估方面，EGPA患者的平均年化HCRU率显著高于匹配队列(p结论：这些真实数据突出了与EGPA相关的巨大经济负担，其特征是HCRU增加、成本和生产力损失，强调了有效管理策略的必要性。

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Healthcare Resource Utilisation and Costs in Patients with Eosinophilic Granulomatosis with Polyangiitis: A Retrospective Analysis of German Insurance Claims Data.

Introduction: Evidence is limited on the clinical and economic burden of eosinophilic granulomatosis with polyangiitis (EGPA) in Europe. We evaluated EGPA healthcare resource utilisation (HCRU), days off work, and costs in Germany.

Methods: This analysis used claims data from the German statutory health insurance fund AOK Plus. Patients with newly diagnosed EGPA (index date 2016-2020; ≥ 12 months pre-diagnosis health plan enrolment) were matched (1:4) with general insured individuals without EGPA. Baseline was 12 months pre-diagnosis; follow-up was until 31 December 2020, insurance disenrollment, or death. Outcomes included HCRU and related costs and days off work.

Results: The study included 155 patients and 620 matched individuals. In the EGPA cohort, all-cause HCRU was higher post-diagnosis than during baseline in all categories. Mean annualised in-patient hospitalisations/patient and pharmacy claims/patient for any EGPA therapy were 2.99 and 5.87, respectively, during 1-year post-diagnosis versus 1.15 and 1.80, respectively, during baseline. Mean total annualised cost of all-cause HCRU/patient with EGPA was €19,700 during 1-year post-diagnosis versus €6,678 during baseline, with in-patient hospitalisations and pharmacy costs the main cost drivers of EGPA care. Over 5 years post-diagnosis, mean annualised HCRU rate per patient was significantly higher for the EGPA versus the matched cohort for all evaluated aspects of HCRU (p < 0.001). The mean total annualised all-cause HCRU cost was sevenfold higher (EGPA €14,771/patient vs matched cohort €2,094/patient; p < 0.001). In-patient hospitalisation (€8,276/patient) was the single largest driver of all-cause costs over 5 years post-diagnosis. Mean total days off work and associated annualised costs of productivity loss were also significantly higher over 5 years post-diagnosis in the EGPA versus the matched cohort (30.74 vs 13.35 days/year; €3,632 vs €1,555 annually/patient, both p < 0.001).

Conclusions: These real-world data highlight the substantial economic burden associated with EGPA, characterised by increased HCRU, costs and productivity losses, underscoring the need for effective management strategies.

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来源期刊

Rheumatology and Therapy RHEUMATOLOGY-

CiteScore

6.00

自引率

5.30%

发文量

审稿时长

6 weeks

期刊介绍： Aims and Scope Rheumatology and Therapy is an international, open access, peer reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world and health outcomes research around the discovery, development, and use of rheumatologic therapies. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed. Areas of focus include, but are not limited to, rheumatoid arthritis, gout, gouty arthritis, psoriatic arthritis, osteoarthritis, juvenile idiopathic/rheumatoid arthritis, systemic lupus erythematosus, axial spondyloarthritis, Pompe’s disease, inflammatory joint conditions, musculoskeletal conditions, systemic sclerosis, and fibromyalgia. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial protocols, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Rheumatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research. Ethics and Disclosures The journal is a member of the Committee on Publication Ethics (COPE) and subscribes to its principles on how to deal with acts of misconduct thereby committing to investigate allegations of misconduct in order to ensure the integrity of research. Content in this journal is peer-reviewed (Single-blind). 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