Healthcare expenditures for males with haemophilia and employer-sponsored insurance in the United States, 2008
Healthcare expenditures for males with haemophilia and employer-sponsored insurance in the United States, 2008
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DOI：
10.1111/j.1365-2516.2011.02692.x
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发表时间：
2012-03-01
期刊：
影响因子：
3.9
通讯作者：
Soucie, J. M.
中科院分区：
文献类型：
--
作者：
Guh, S.;Grosse, S. D.;Soucie, J. M.
。虽然血友病具有潜在的高经济影响，但公布的美国血友病患者的医疗保健费用估计很少，而且对于该疾病的非出血并发症也没有特异性。本研究的目的是估计雇主赞助的血友病保险覆盖的血友病患者的平均年度医疗保健支出，并根据年龄、血友病类型[A（因子VIII缺乏症）与B（因子IX）]、中和性同种抗体抑制剂的存在和暴露于血源性病毒感染的影响进行分层。来自MarketScan (R)商业和医疗保险研究数据库的数据在2002-2008年期间被用来确定血友病病例，并估计2008年期间的平均和中位数医疗支出。2008年，共有1164名男性血友病患者被连续纳入研究，其中933名血友病患者为A型血友病患者，231名血友病患者为b型血友病患者。平均医疗费用为155,136美元[中位数为73,548美元]。30名（3%）男性使用抑制剂的平均成本比未使用抑制剂的男性高5倍，分别约为69.7万美元（中位数为330835美元）和14.4万美元（中位数为73321美元）。凝血因子浓缩物占总成本的70% ~ 82%。207名感染丙型肝炎病毒或艾滋病毒的成年人的平均费用比未感染的成年人高1.5倍。血友病的治疗是昂贵的，特别是对于需要旁路药物的中和性同种抗体抑制剂的个体。需要努力了解抑制剂的原因，以便实施预防策略，并避免血友病护理这一严重并发症造成的额外费用。
. Although hemophilia has a potentially high economic impact, published estimates of health care costs for Americans with hemophilia are sparse and non-specific as to the non-bleeding complications of the disease. The objective of this study is to estimate average annual health care expenditures for people with hemophilia covered by employer-sponsored insurance, stratified according to the influence of age, type of hemophilia [A (factor VIII deficiency) versus B (factor IX)], presence of neutralizing alloantibody inhibitors and exposure to blood-borne viral infections. Data from the MarketScan (R) Commercial and Medicare Research Databases were used for the period 2002-2008 to identify cases of hemophilia and to estimate mean and median medical expenditures during 2008. A total of 1,164 males with hemophilia were identified with continuous enrollment during 2008, 933 with hemophilia A and 231 with hemophilia B. Mean health care expenditures were $155,136 [median $73,548]. Mean costs for 30 (3%) males with an inhibitor were 5 times higher than for males without an inhibitor, approximately $697,000 [median $330,835] and $144,000 [median $73,321], respectively. Clotting factor concentrate accounted for 70%82% of total costs. Average costs for 207 adults with HCV or HIV infection were 1.5 times higher than those for adults without infection. Hemophilia treatment is costly, particularly for individuals with neutralizing alloantibody inhibitors who require bypassing agents. Efforts to understand the cause of inhibitors are needed so that prevention strategies can be implemented and the excess costs resulting from this serious complication of hemophilia care can be avoided.