患有非功能性垂体腺瘤的患者的医疗费用和生存率
Daniel S Olsson1,2,3, Mikael Svensson4,5, Frida Labori5
1Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden.
European journal of endocrinology
|May 26, 2023
概括
在非功能性垂体腺瘤 (NFPA) 患者中,生长激素 (GH) 替代增加了预期寿命,但也增加了医疗费用. 每个获得的生命年成本约为37,000欧元,上腺功能不全和无味糖尿病影响了成本和生存.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
背景情况:
- 垂体腺瘤,特别是非功能性垂体腺瘤 (NFPA),显著影响患者的死亡率和发病率.
- 了解治疗对经济和生存的影响对于管理NFPA至关重要.
研究的目的:
- 评估NFPA患者的医疗费用,生存率和生长激素 (GH) 替代疗法的成本效益与没有GH替代疗法的成本效益.
- 确定影响NFPA患者医疗费用和生存的因素.
主要方法:
- 一项回顾性队列研究包括来自瑞典Västra Götaland地区的426名NFPA患者,从1987年至2019年12月31日进行了跟踪.
- 关于资源利用,成本,存活率和成本效益的数据从患者记录和区域/国家医疗保健登记处收集.
主要成果:
- 接受GH的患者的年度医疗费用总额 (9287欧元) 比不接受GH的患者 (6770欧元) 高,主要是由于药品费用.
- GH替代与更高的生存率相关 (HR 0.60;P = .01).
- 诸如葡萄糖皮质激素替代剂,无味糖尿病,较高的BMI和高血压等因素与医疗保健成本的增加有关. 葡萄糖皮质体替代剂 (HR 2.02;P < .01) 和无味糖尿病 (HR 1.67;P = .04) 减少了生存时间.
结论:
- 增生激素替代,上腺功能不足和无味糖尿病是NFPA患者医疗保健成本的关键驱动因素.
- 补充GH改善了预期寿命,而上腺功能衰竭和无味糖尿病则减少了预期寿命.
- 通过GH替代获得的每生命年成本约为37,000欧元.
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