Pharmacoeconomic study of patients with chronic inflammatory joint disease before and during infliximab treatment
Pharmacoeconomic study of patients with chronic inflammatory joint disease before and during infliximab treatment
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DOI：
10.1136/ard.2005.041574
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发表时间：
2006-07-01
影响因子：
27.4
通讯作者：
Leirisalo-Repo, M
中科院分区：
文献类型：
--
作者：
Laas, K;Peltomaa, R;Leirisalo-Repo, M
目的：评估常规临床实践中慢性炎症性关节病患者接受英夫利昔单抗治疗前一年和治疗后一年的医疗和工作伤残费用。 方法：从 1999 年开始，赫尔辛基大学中心医院系统记录了接受生物制剂治疗炎症性风湿病患者的临床和实验室变量。从该数据库中收集了 1999 年至 2001 年期间开始使用英夫利昔单抗的 96 名患者的临床信息。经济分析基于门诊和住院就诊、骨科手术、使用的药物以及病假或康复津贴所产生的费用。分别计算英夫利昔单抗治疗前一年（第一期）和英夫利昔单抗治疗后一年（第二期）的医疗和工作残疾费用。 结果：研究组有 96 名患者（关节炎病程 16 年（范围 3 至 43）），其中 74 人完成了一年的英夫利昔单抗治疗。他们的临床和实验室变量显着改善。第二期医疗费用平均增加 12 欧元 015（95% 置信区间，6496 至 18 076）。工作伤残费用略有下降——平均下降 130 欧元（-1268 至 1072）。结论：长期侵袭性关节炎患者接受英夫利昔单抗治疗一年显示出良好的临床效果，但显着增加了医疗费用。工作伤残成本并未出现大幅下降。从长远来看，在慢性关节炎的早期阶段开始使用英夫利昔单抗可以预防工作残疾，从而降低社会的总成本。
Objective: To evaluate medical and work disability costs for patients with chronic inflammatory joint disease during one year before and one year after institution of infliximab treatment in routine clinical practice.Methods: Starting from 1999, clinical and laboratory variables for patients treated with biological agents for inflammatory rheumatic diseases were systematically recorded at Helsinki University Central Hospital. From this database clinical information was collected on 96 patients in whom infliximab was started during the period 1999 to 2001. Economic analyses were based on costs incurred because of outpatient and inpatient visits, orthopaedic operations, drugs used, and days on sickness or rehabilitation allowance. Medical and work disability costs were calculated separately for the one year period before (period I) and the one year period after institution of infliximab (period II).Results: Of the study group of 96 patients (arthritis duration 16 years (range 3 to 43)), 74 completed one year of infliximab treatment. Their clinical and laboratory variables improved significantly. The mean increase in medical costs during period II was 12euro 015 (95% confidence interval, 6496 to 18 076). A minimal decrease in work disability costs occurred - mean decrease 130euro (-1268 to 1072).Conclusions: One year treatment with infliximab in patients with longstanding aggressive arthritis showed a good clinical effect but raised medical costs significantly. Work disability costs failed to show a substantial decrease. Starting infliximab in the earlier stages of chronic arthritis could in the long term prevent work disability and thus decrease the total cost to society.