Direct costs of adhering to selected Duchenne muscular dystrophy Care Considerations: Estimates from a midwestern state.
Direct costs of adhering to selected Duchenne muscular dystrophy Care Considerations: Estimates from a midwestern state.
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作者：
多学科杜氏肌营养不良症(DMD)护理考虑是为了标准化护理和改善结果。我们提供了八个领域(神经肌肉、康复、呼吸、心脏、骨科、胃肠、内分泌、心理社会管理)护理考虑因素中选定的关键预防性(即，不包括新的分子疗法和急性护理)要素的累积成本估计，独立于吸收或提供非预防性护理的完整性。我们使用了2018年中西部一家大型商业健康保险公司的未识别保险索赔数据。我们使用当前的程序术语和国家药品代码来提取临床接触的单位成本，这些单位成本代表了DMD护理考虑的关键预防要素。我们预测了这些因素从5岁到25岁的每位患者的累积成本，方法是将推荐的预防服务频率时间表乘以2018年的单位成本(以美元计)。假设在5岁时确诊，11岁时独立行走，25岁时存活，我们估计了670个可收费的临床事件。使用泼尼松的20年每位患者的累积成本为174 701美元(使用flecazacort的为230万美元)，预计与这些事件和药物相关的自付费用总额为12 643美元(29 194美元)。对疾病进展和治疗的标准化监测可能会降低疾病的总体成本。将需要与这些服务相关的成本来量化潜在的节省。我们的方法展示了一种估计与实施预防性护理计划相关的成本的方法。
The multidisciplinary Duchenne muscular dystrophy (DMD) Care Considerations were developed to standardize care and improve outcomes. We provide cumulative cost estimates for selected key preventive (ie, excluding new molecular therapies and acute care) elements of the care considerations in eight domains (neuromuscular, rehabilitation, respiratory, cardiac, orthopedic, gastrointestinal, endocrine, psychosocial management) independent of completeness of uptake or provision of nonpreventive care. We used de-identified insurance claims data from a large midwestern commercial health insurer during 2018. We used Current Procedural Terminology and national drug codes to extract unit costs for clinical encounters representing key preventive elements of the DMD Care Considerations. We projected per-patient cumulative costs from ages 5 to 25 years for these elements by multiplying a schedule of recommended frequencies of preventive services by unit costs in 2018 US dollars. Assuming a diagnosis at age 5 years, independent ambulation until age 11, and survival until age 25, we estimated 670 billable clinical events. The 20-year per-patient cumulative cost was $174 701 with prednisone ($2.3 million with deflazacort) and an expected total of $12 643 ($29 194) for out-of-pocket expenses associated with those events and medications. Standardized monitoring of disease progression and treatments may reduce overall costs of illness. Costs associated with these services would be needed to quantify potential savings. Our approach demonstrates a method to estimate costs associated with implementation of preventive care schedules.
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影响因子：
2.8
作者：
Eagle, M;Baudouin, SV;Bushby, K
通讯作者：
Bushby, K
DOI：
10.1371/currents.md.2cc69a1dae4be7dfe2bcb420024ea865
发表时间：
2013-12-12
期刊：
PLoS currents
影响因子：
--
作者：
Allen, Hugh D;Flanigan, Kevin M;Mendell, Jerry R
通讯作者：
Mendell, Jerry R
影响因子：
3.5
作者：
Dijkstra, RF;Niessen, LW;Grol, RTPM
通讯作者：
Grol, RTPM
影响因子：
6.1
作者：
Klebe, Bernhard;Irving, Jean;Farmer, Christopher K. T.
通讯作者：
Farmer, Christopher K. T.
DOI：
10.1097/hjr.0b013e328329497a
发表时间：
2009-06-01
影响因子：
--
作者：
Kok, Linda;Engelfriet, Peter;Verschuren, Monique W. M.
通讯作者：
Verschuren, Monique W. M.