Costs of Providing Infusion Therapy for Rheumatoid Arthritis in a Hospital-based Infusion Center Setting
Costs of Providing Infusion Therapy for Rheumatoid Arthritis in a Hospital-based Infusion Center Setting
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DOI：
10.1016/j.clinthera.2017.06.007
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发表时间：
2017-08-01
影响因子：
3.2
通讯作者：
Garg, Vishvas
中科院分区：
文献类型：
--
作者：
Schmier, Jordana;Ogden, Kristine;Garg, Vishvas
目的：许多以医院为基础的输液中心用静脉注射生物制剂治疗类风湿性关节炎（RA）患者，但可能对这种情况下输液的总体成本了解有限。本研究的目的是从医院的角度进行微观成本分析，并开发一个模型，使用基于活动的成本计算方法来估计与在美国提供医院输液服务（准备，给药和随访）相关的成本，以维持中重度RA的治疗。方法：建立基于电子表格的模型。输入包括小时工资、提供护理的时间、供应/间接成本、实验室测试、输液中心规模和实践模式信息。基本情况值来源于调查数据、已发表的研究、标准成本来源和专家意见。成本以2017年美元表示。基本案例模拟了一个医院输液中心，为接受阿巴接受、托珠单抗、英夫利昔单抗或利妥昔单抗治疗的RA患者提供服务。研究结果：估计每位患者每年输注的总成本为36,663美元（利妥昔单抗），36,821美元（托珠单抗），44,973美元（英夫利昔单抗）和46,532美元（阿巴接受）。在所有疗法中，生物制剂占总成本的最大份额，每年占总成本的87%至91%不等。不包括输液药物成本，人工成本占输液成本的53% - 57%。(C) 2017年作者。由Elsevier HS Journals， Inc.出版。
Purpose: Many hospital-based infusion centers treat patients with rheumatoid arthritis (RA) with intravenous biologic agents, yet may have a limited understanding of the overall costs of infusion in this setting. The purposes of this study were to conduct a microcosting analysis from a hospital perspective and to develop a model using an activity-based costing approach for estimating costs associated with the provision of hospital-based infusion services (preparation, administration, and follow-up) in the United States for maintenance treatment of moderate to severe RA.Methods: A spreadsheet-based model was developed. Inputs included hourly wages, time spent providing care, supply/overhead costs, laboratory testing, infusion center size, and practice pattern information. Base-case values were derived from data from surveys, published studies, standard cost sources, and expert opinion. Costs are presented in year-2017 US dollars. The base case modeled a hospital infusion center serving patients with RA treated with abatacept, tocilizumab, infliximab, or rituximab.Findings: Estimated overall costs of infusions per patient per year were $36,663 (rituximab), $36,821 (tocilizumab), $44,973 (infliximab), and $46,532 (abatacept). Of all therapies, the biologic agents represented the greatest share of overall costs, ranging from 87% to $91% of overall costs per year. Excluding infusion drug costs, labor accounted for 53% to 57% of infusion costs. (C) 2017 The Authors. Published by Elsevier HS Journals, Inc.