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首页> 外文期刊>Rheumatology >Cost of illness in rheumatoid arthritis in Germany in 1997-98 and 2002: cost drivers and cost savings.
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Cost of illness in rheumatoid arthritis in Germany in 1997-98 and 2002: cost drivers and cost savings.

机译：1997-98年和2002年德国风湿性关节炎的疾病成本：成本驱动因素和成本节省。

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OBJECTIVE: Comparison of overall RA-related costs and of relative contribution of single-cost domains before and after the introduction of TNF-blocking agents in Germany. METHODS: Two cohorts of RA outpatients (ACR '87 criteria) with long-standing disease are assessed in terms of disease-related costs and cost composition (n = 106 patients in 1997-98 and n = 180 patients in 2002 with similar patient characteristics). Full-cost analyses are performed including direct disease-related costs (medical and non-medical) and productivity costs as collected by patient questionnaires. Absolute costs (euro/patient/year) are compared and the impact of single-cost domains on overall costing in RA is estimated (relative proportions of cost components within samples). RESULTS: Overall costs are comparable (1997-98: euro4280; 2002: euro3830; not significant). Differences can be observed in medication (1997-98: euro550; 2002: euro1580; P < 0.001) and hospitalization costs (1997-98: euro1240; 2002: euro500; P < 0.001). Productivity costs are significantly lower (euro1480 vs euro850; P < 0.05) in 2002. The impact of medication costs is outstanding in the 2002 sample (42 vs 12%), the proportion of hospitalization costs is substantially lower (29 vs 13%). Costs for DMARDs in 2002 are mostly driven by TNF blockers (37%). The number of DMARDs per patient is higher in 2002 as are costs for osteoporosis medication and gastroprotective treatment. CONCLUSION: Although overall costs before and after the introduction of TNF blockers are comparable, the decrease in hospitalization and productivity costs is promising in terms of future long-term cost savings. The development of these aspects and of the increasing medication costs will have to be evaluated with longer time frames.
机译：目的：比较在德国引入TNF阻断剂之前和之后与RA相关的总成本和单一成本域的相对贡献。方法：根据疾病相关的成本和成本构成对两组患有长期疾病的RA门诊患者（ACR '87标准）进行了评估（1997-98年度为n = 106例患者，2002年度为n = 180例，具有相似的患者特征） ）。进行全成本分析，包括直接通过患者问卷收集的疾病相关成本（医学和非医学）和生产力成本。比较绝对成本（欧元/患者/年），并评估单一成本域对RA总体成本的影响（样本中成本成分的相对比例）。结果：总体成本是可比的（1997-98年：4280欧元; 2002年：3830欧元;不重大）。可以观察到药物治疗（1997-98：euro550; 2002：euro1580; P <0.001）和住院费用（1997-98：euro1240; 2002：euro500; P <0.001）之间的差异。 2002年的生产成本显着降低（euro1480对euro850; P <0.05）。在2002年的样本中，药物成本的影响显着（42％对12％），住院费用所占比例显着降低（29％对13％）。 2002年DMARD的成本主要由TNF阻滞剂（37％）驱动。 2002年每名患者的DMARD数量增加，骨质疏松症药物和胃保护治疗的费用也更高。结论：尽管在引入TNF阻滞剂之前和之后的总体成本是可比的，但就未来的长期成本节省而言，住院和生产成本的下降是有希望的。这些方面的发展以及不断增加的药物成本将不得不在更长的时间内进行评估。

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