全国多中心类风湿关节炎患者门诊用药费用的调查
전국다중심류풍습관절염환자문진용약비용적조사
A multicenter study of costs of drugs in rheumatoid arthritis in China
  • 万方数据
    中华风湿病学杂志 중화풍습병학잡지
    CHINESE JOURNAL OF RHEUMATOLOGY
    2010年 6期 368-372 ,共5页

    王秀茹%苏茵%安媛%周云杉%王莉枝%王彩虹%李小峰%陈丽娜%朱平%卢昕%王国春%靳洪涛%杨荣%王永福%李光韬%张卓莉%孙琳%刘湘源%陶杰梅%张风肖%杨静%李振彬%韦美秋%林金盈%舒荣%崔刘福%柯丹%刘晓敏%叶丛%胡绍先%李昊%杨岫岩%赖蓓%高明%黄慈波%宋立军%李兴福%栗占国

    왕수여%소인%안원%주운삼%왕리지%왕채홍%리소봉%진려나%주평%로흔%왕국춘%근홍도%양영%왕영복%리광도%장탁리%손림%류상원%도걸매%장풍초%양정%리진빈%위미추%림금영%서영%최류복%가단%류효민%협총%호소선%리호%양수암%뢰배%고명%황자파%송립군%리흥복%률점국

    关节炎,类风湿%药费支出%数据收集 關節炎,類風濕%藥費支齣%數據收集
    관절염,류풍습%약비지출%수거수집
    Arthritis,rheumatoid%Drug costs%Data collection
    目的 了解我国类风湿关节炎(RA)患者的门诊药费情况,分析药费的影响因素和不同人群药费的差别.方法 面对面调查646例RA患者的回顾性用药情况,同时记录患者的一般资料、临床特点及关节功能状态评分.将其中病程1年以上并且药费资料完整的435例纳入分析,根据用药情况估计过去1年的药费,分析了药费与人口学特征、临床特点的关系,并评估不同药物的性价比.结果 ①RA患者过去1年内的人均门诊药费为人民币(8018±17 238)元,其中改善病情药的费用人均(1610±2138)元,占总药费的20%;生物制剂人均(3975±17 071)元,占总药费的49%;非甾体抗炎药的人均费用为(353±829)元,占总药费的4%;植物药人均费用为(1769±3528)元,占总药费的22%;人均激素费用为(48±160)元,外用药(74±386)元,各占药费的1%.②门诊药费相关因素分析显示,伴有关节外表现(OR:2.180,95%CI:1.335～3.558,P=0.002)、患者功能状态差(OR:1.373,95%CI:1.012～1.863,P=0.04.1)为导致药费增高的相关因素.③不同人群的药费分析提示大学以上学历、脑力劳动、月收入>3000元、享受公费医疗的人群的改善病情抗风湿药(DMARDs)的费用高,门诊患者及功能状态好的患者的DMARDs的费用高.④不同药物的性价比分析显示DMARDs药物的性价比更高.结论 RA患者每年药费高,其中生物制剂、改善病情药及植物药占药费的主要部分,伴有关节外表现和患者功能状态差是高药费的相关因素.人群的学历、收入、付费方式均影响各项药费的分布.DMARDs药物的性价比更高.
    목적 료해아국류풍습관절염(RA)환자적문진약비정황,분석약비적영향인소화불동인군약비적차별.방법 면대면조사646례RA환자적회고성용약정황,동시기록환자적일반자료、림상특점급관절공능상태평분.장기중병정1년이상병차약비자료완정적435례납입분석,근거용약정황고계과거1년적약비,분석료약비여인구학특정、림상특점적관계,병평고불동약물적성개비.결과 ①RA환자과거1년내적인균문진약비위인민폐(8018±17 238)원,기중개선병정약적비용인균(1610±2138)원,점총약비적20%;생물제제인균(3975±17 071)원,점총약비적49%;비치체항염약적인균비용위(353±829)원,점총약비적4%;식물약인균비용위(1769±3528)원,점총약비적22%;인균격소비용위(48±160)원,외용약(74±386)원,각점약비적1%.②문진약비상관인소분석현시,반유관절외표현(OR:2.180,95%CI:1.335～3.558,P=0.002)、환자공능상태차(OR:1.373,95%CI:1.012～1.863,P=0.04.1)위도치약비증고적상관인소.③불동인군적약비분석제시대학이상학력、뇌력노동、월수입>3000원、향수공비의료적인군적개선병정항풍습약(DMARDs)적비용고,문진환자급공능상태호적환자적DMARDs적비용고.④불동약물적성개비분석현시DMARDs약물적성개비경고.결론 RA환자매년약비고,기중생물제제、개선병정약급식물약점약비적주요부분,반유관절외표현화환자공능상태차시고약비적상관인소.인군적학력、수입、부비방식균영향각항약비적분포.DMARDs약물적성개비경고.
    Objective To describe the distribution of medication costs of rheumatoid arthritis patients, and to analyze the factors that may affect the costs. Methods Data were obtained from a 12-month retrospective investigation of patients with rheumatoid arthritis (RA) across China. Department of Rheuma-tology of 18 hospitals were randomly selected. The data about their social conditions, clinical conditions, medications associated with RA such as disease-modifying antirheumatic drugs (DMARDs), non -steroidal anti -inflammtory drugs (NSAIDs), steroids, biologic agents were collected, and the costs of drugs were calculated. A non-parameter test and multivariate logistic regression analysis were performed. Results Six hundred and forty six patients were enrolled into the study, 435 completed data were chosen for analysis. The results demonstrated that the average costs per patient for medications in the past year was 8018 . The total medication costs were further subdivided into the following parts: DMARDs, (represented 20% of the total costs), biologic drugs (49%), NSAIDs (4%), herbal drugs (22%), steroids (1%). Data analysis showed that patients with higher education and higher incomes, with medical insurance,better health function status and outpatients paid more on DMARDs. Extra-articular manifestations increased the odds of the high-cost group (OR: 2.180, 95%CI: 1.335～3.558, P=0.002), while poor health function status increased the probability of paying high costs (OR: 1.373, 95%CI: 1.012～1.863, P=0.041). Conclusion High medication costs in RA do exist in RA patients. The costs of medication is associated with health function status and the presence of extra-articular manifestations.
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