The social and economic burden of venous leg ulcers - Focus on the role of micronized purified flavonoid fraction adjuvant therapy
The social and economic burden of venous leg ulcers - Focus on the role of micronized purified flavonoid fraction adjuvant therapy
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DOI：
10.2165/00128071-200304080-00007
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发表时间：
2003-01-01
影响因子：
7.3
通讯作者：
Majewski, E
中科院分区：
文献类型：
--
作者：
Simka, M;Majewski, E
慢性静脉功能不全（CVI）在人口中所占比例相对较高，并且与高发病率、高医疗成本、生产力损失和生活质量下降相关。据估计，在发达国家，与 CVI 相关的下肢溃疡影响着 0.2-1% 的人口。在美国，静脉溃疡的患病率估计为 500 000-600 000，并且随着年龄的增长而增加。英国和瑞士腿部溃疡的年发病率估计分别为每 1000 人 3.5 例和 0.2 例。静脉溃疡的治疗费用昂贵，给许多国家的卫生服务造成巨大的经济负担。据估计，美国 CVI 的年度成本超过 10 亿美元，英国则为 400-6 亿英镑。目前 CVI 的治疗方法包括手术、硬化疗法、压迫疗法（常规疗法）和辅助药物疗法。各种药物已被用作辅助治疗，但在许多情况下，没有明确的证据证明其疗效。腿部静脉溃疡的有效治疗方案可以大大减少 CVI 对卫生服务的经济影响。在对照研究中，与单独使用传统疗法相比，微粉化纯化黄酮类成分 (MPFF) 辅助疗法已被证明可以显着增加治愈的静脉性腿部溃疡的数量，并显着缩短溃疡的愈合时间，从而可能改善患者的生活质量。研究还发现，与单独使用传统疗法相比，使用 MPFF 治疗腿部静脉溃疡可以降低总体治疗成本。在仅基于直接医疗费用的回顾性成本效益分析中，MPFF治疗与传统疗法相比，成本效益比提高了45%。如果包括生活质量损失等无形成本，成本效益比的差异可能会更大，有利于强积金。敏感性分析表明，即使药品价格上涨 20%，MPFF 治疗的成本效益比仍明显优于传统治疗（每个溃疡愈合分别为 1061.8 美元和 1871.9 美元）。因此，在腿部静脉性溃疡的治疗中加入 MPFF 辅助治疗将是有效的，并且可能节省成本。
Chronic venous insufficiency (CVI) occurs in a relatively large proportion of the population and is associated with significant morbidity, high cost of healthcare, loss of productivity and reduced quality of life. Lower extremity ulcers related to CVI have been estimated to affect 0.2-1% of the population in developed countries. The prevalence of venous ulcers in the US is estimated at 500 000-600 000, and increases with age. Estimates of the annual incidence of leg ulcer in the UK and Switzerland are 3.5 and 0.2 per 1000 individuals, respectively. Treatment of venous ulcers can be expensive, leading to a large economic burden on health services in many countries. The annual cost of CVI is estimated to be more than $US 1 billion in the US and between pound400-600 million in the UK. Current treatments for CVI include surgery, sclerotherapy, compressive therapy (conventional therapy) and adjuvant pharmacotherapy. Various pharmacological agents have been used as adjuvant therapy but in many cases there is no definitive evidence of their efficacy.Effective treatment programs for venous leg ulcers could substantially reduce the economic impact of CVI on health services. In controlled studies, micronized purified flavonoid fraction (MPFF) adjuvant therapy has been shown to increase significantly the number of healed venous leg ulcers and to reduce significantly the healing time of ulcers compared with conventional therapy alone, potentially leading to an improvement in patients' quality of life. The treatment of venous leg ulcers with MPFF was also found to reduce overall treatment costs compared with conventional therapy alone. In a retrospective cost-effectiveness analysis based on direct medical costs only, MPFF therapy improved the cost-effectiveness ratio by 45% compared with conventional therapy. If intangible costs, such as loss of quality of life were included, the difference in cost-effectiveness ratios is likely to be even greater in favor of MPFF. Sensitivity analyzes showed that even with a 20% increase in drug price the cost-effectiveness ratio for MPFF therapy was substantially better than that for conventional therapy ($US 1061.8 vs 1871.9 per ulcer healed). Hence, the addition of MPFF adjuvant therapy to the treatment of venous leg ulcers would be effective and potentially cost saving.