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首页> 外文期刊>ClinicoEconomics and Outcomes Research >Treatment patterns and economic outcomes in patients with juvenile idiopathic arthritis
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Treatment patterns and economic outcomes in patients with juvenile idiopathic arthritis

机译：幼年特发性关节炎患者的治疗方式和经济效益

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Purpose: To describe health care resource utilization (HCRU) and costs among patients with juvenile idiopathic arthritis (JIA) compared to patients without JIA and to describe treatment patterns among JIA patients who initiated biologic and non-biologic disease-modifying antirheumatic drugs (DMARDs). Patients and methods: The IBM MarketScansup?,/sup Commercial Database was used to identify patients aged 2–17 years with a new JIA diagnosis (index date) and 12 months continuous enrollment pre- and post-diagnosis from 2008 to 2016. JIA patients were matched to non-JIA patients on age, gender, region, and health plan type. Patients with other rheumatic or autoimmune conditions were excluded. Receipt of a biologic and/or non-biologic was evaluated on or after the new JIA diagnosis. Results: A total of 3,815 JIA patients were matched to 11,535 non-JIA patients (mean age 10.0 [SD=4.5], 69% female). Average total costs were greater for JIA patients than non-JIA controls ($18,611 [SD=$42,104; median=$8,189] versus $2,203 [SD=$9,309; median=$649], p 0.001). Outpatient pharmacy costs were 33.6% of the total costs among JIA patients compared to 18.4% among non-JIA patients ( p 0.001). The proportion of inpatient cost (11.4% versus 14.3%, p 0.001) and outpatient costs (55% versus 67.4%, p 0.001) of total costs was lower among JIA patients compared to non-JIA patients. Patients with 12 months of continuous enrollment post-treatment initiation (n=2,014) were classified as non-biologic only (n=734), biologic only (n=873), and both biologic and non-biologic (n=407) users. Among biologic and non-biologic users, 41.1% and 56.8% were persistent on their index medication for 12 months. Of patients treated with a biologic only, TNF inhibitors (TNFi) comprised 87.1% of the total treatment costs. Conclusion: JIA is associated with increased costs and utilization in every HCRU category compared to matched non-JIA patients. While JIA-related costs varied by treatment cohort, patients on biologic DMARDs had substantially higher costs than patients on non-biologic DMARDs and fewer than one-half were persistent at 12 months after biologic initiation.
机译：目的：描述青少年特发性关节炎（JIA）患者与没有JIA的患者之间的卫生保健资源利用（HCRU）和费用，并描述在开始使用生物和非生物疾病缓解风湿病药物（DMARD）的JIA患者中的治疗方式。患者和方法：使用IBM MarketScan ？商业数据库来识别2-17岁，具有新的JIA诊断（索引日期）以及自2008年起连续12个月的诊断前和诊断后的患者至2016年。根据年龄，性别，地区和健康计划类型，JIA患者与非JIA患者匹配。患有其他风湿性或自身免疫性疾病的患者被排除在外。在新的JIA诊断中或之后评估了生物学和/或非生物学的收据。结果：总共3,815名JIA患者与11,535名非JIA患者（平均年龄10.0 [SD = 4.5]，女性占69％）相匹配。 JIA患者的平均总费用比非JIA对照要高（$ 18,611 [SD = $ 42,104;中位数= $ 8,189]与$ 2,203 [SD = $ 9,309;中位数= $ 649]，p <0.001）。 JIA患者的门诊药房费用占总费用的33.6％，而非JIA患者则为18.4％（p <0.001）。与非JIA患者相比，JIA患者的住院费用（11.4％对14.3％，p <0.001）和门诊费用（55％对67.4％，p <0.001）的比例较低。治疗后连续入组12个月（n = 2,014）的患者被分类为仅非生物学（n = 734），仅生物学（n = 873）和生物学和非生物学（n = 407）用户。在生物和非生物使用者中，有41.1％和56.8％的患者坚持使用索引药物治疗12个月。在仅接受生物制剂治疗的患者中，TNF抑制剂（TNFi）占总治疗费用的87.1％。结论：与匹配的非JIA患者相比，JIA与每个HCRU类别的成本和利用率增加相关。虽然JIA相关费用因治疗队列而异，但使用生物DMARD的患者的费用要比使用非生物DMARD的患者高得多，并且在开始生物治疗12个月后，持续性费用不到二分之一。

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