Severity index for rheumatoid arthritis and its association with health care costs and biologic therapy use in Turkey

被引：10

作者：

Baser O. ^{[1
,2
]}

Baser E. ^{[3
]}

Altinbas A. ^{[4
]}

Burkan A. ^{[5
]}

机构：

[1] Internal Medicine Department, Rheumatology Division, The University of Michigan, Ann Arbor, MI 48104, 211 N 4th Avenue

[2] STATinMED Research, Ann Arbor, MI 48104, 211 North 4th Avenue

[3] STATinMED Research, 34010SJsJi, Istanbul, Trump Towers, Buyukdere Caddesi, Jehit Ahmet Sokak

[4] Gastroenterology Clinic, Diskapi Yildrm Beyazit Teaching and Research Hospital,Irfan Bastug CadDiskapi, 06100, Ankara

[5] Program Development, Social Security Institution, 06520 Balgat, Ankara

来源：

Health Economics Review | / 3卷 / 1期

关键词：

Medical costs; Outcomes research; Real-world data analysis; Rheumatoid arthritis; Severity index;

D O I：

10.1186/2191-1991-3-5

中图分类号：

学科分类号：

摘要：

Objective: This study aimed to apply the previously validated severity index for rheumatoid arthritis (SIFRA) to prevalent rheumatoid arthritis (RA) groups in Turkey and determine the effect of RA severity on health care costs and biologic use. Methods: This retrospective study used the Turkish national health insurance database MEDULA (June 1, 2009-December 31, 2011). Prevalent RA patients were required to be age 18 to 99, have two RA diagnoses at least 60 days apart and be continuously enrolled 1 year prior to (baseline period) and post (follow-up period) index date, which was the first RA claim during the identification period (June 1, 2010-December 31, 2010). SIFRA was calculated for the baseline period. Total health care costs and biologic use were examined for the follow-up period. The chi-square test was used to determine the association between SIFRA score terciles and outcomes. Generalized linear models were applied to determine health care costs while multivariate logistic regression determined the effect of SIFRA on outcome measures for biologic use. Results: A total of 1,920 patients were identified. The mean SIFRA score was 14.21, and 7.05 (49.57%) of the mean composed of clinical and functional status variables, followed by 6.32 (44.47%) for medications, 0.48 (3.40%) for radiology and laboratory findings, and 0.32 (2.25%) for extra-articular manifestation. There was a significant variation in scores across cities. After controlling for age, gender, region, and comorbidity index, patients in the high SIFRA tercile were 5.16 times more likely to be prescribed biologics (p<0.001, confidence interval [CI]: 3.46-7.69), and incurred annual health care costs that were €2,091 higher (p<0.001, CI: €,557 - €2,625) than those in the low SIFRA score tercile. Conclusion: RA severity varies throughout Turkey and is a significant determinant of health care costs and biologic therapy use. Therefore, future comparative effectiveness studies should include the severity measure in their analysis. © 2013 Baser et al.; licensee Springer.

引用

页码：1 / 7

页数：6

共 29 条

[1]

Markenson J.A., Worldwide trends in the socioeconomic impact and long-term prognosis of rheumatoid arthritis, Semin Arthritis Rheum, 21, 2, pp. 4-12, (1991)

[2]

Lundkvist J., Kastang F., Kobelt G., The burden of rheumatoid arthritis and access to treatment: Health burden and costs, Eur J Health Econ, 8, 2, (2008)

[3]

Alarcon G.S., Epidemiology of rheumatoid arthritis, Rheum Dis Clin North Am, 21, 3, pp. 589-604, (1995)

[4]

Rasch E.K., Hirsch R., Paulose-Ram R., Hochberg M.C., Prevalence of rheumatoid arthritis in persons 60 years of age and older in the United States: Effect of different methods of case classification, Arthritis Rheum, 48, 4, pp. 917-926, (2003)

[5]

Helmick C.G., Felson D.T., Lawrence R.C., Gabriel S., Hirsch R., Kwoh C.K., Liang M.H., Kremers H.M., Mayes M.D., Merkel P.A., Pillemer S.R., Reveille J.D., Stone J.H., National Arthritis Data Workgroup: Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part I, Arthritis Rheum, 58, 1, pp. 15-25, (2008)

[6]

Jonsson B., Kobelt G., Smolen J., The burden of rheumatoid arthritis and access to treatment: Uptake of new therapies, Eur J Health Econ, 8, SUPPL. 2, (2008)

[7]

Kremer J.M., Lee J.K., The safety and efficacy of the use of methotrexate in long term therapy for rheumatoid arthritis, Arthritis Rheum, 29, 7, pp. 822-831, (1986)

[8]

Kahlenberg J.M., Fox D.A., Advances in the medical treatment of rheumatoid arthritis, Hand Clin, 27, 1, pp. 11-20, (2011)

[9]

Scott D., Kingsley G., Tumor necrosis factor inhibitors for rheumatoid arthritis, N Engl J Med, 355, 7, pp. 704-712, (2006)

[10]

Yazici Y., Shi N., John A., Utilization of biologic agents in rheumatoid arthritis in the United States: Analysis of prescribing patterns in 16,752 newly diagnosed patients and patients new to biologic therapy, Bull NYU Hosp Jt Dis, 66, 2, pp. 77-85, (2008)

← 1 2 3 →