公共卫生 公共卫生
Ataru Igarashi1, Noriyuki Kimura2, Temmei Ito3
1The University of Tokyo, Graduate School of Pharmaceutical Sciences, Tokyo, Japan.
实施基于血液的生物标志物 (BBM) 来诊断阿尔茨海默病 (AD) 可以显著减少患者等待疾病修饰疗法 (DMT) 的时间. 这种方法也增加了符合条件的患者数量,改善了及时治疗的机会.
科学领域:
- 神经学 神经学
- 生物标志物研究 生物标志物研究
- 卫生经济学 卫生经济学
背景情况:
- 对于新的疗法,阿尔茨海默氏病 (AD) 诊断需要通过PET或CSF通过粉样β (Aβ) 确认.
- 基于血液的生物标志物 (BBM) 为AD诊断提供了可取的替代方案,但它们对医疗保健系统的影响还未得到充分研究.
- 本研究评估了将BBM纳入AD诊断途径的影响.
研究的目的:
- 估计诊断等待时间和符合AD疾病修饰疗法 (DMT) 患者数量.
- 分析将BBM纳入各种AD诊断流中的经济价值.
- 将四种诊断场景进行比较,包括当前的方法和BBM实施作为分拣或确认测试.
主要方法:
- 一个动态模拟模型被用于估计.
- 对测试的需求通过在线调查评估了3302名参与者,基于对诊断测试的支付意愿 (WTP).
- 模拟了四种诊断场景:电流,BBM作为分拣,BBM作为确认,BBM作为分拣和确认.
主要成果:
- 支付AD诊断测试的意愿 (WTP) 根据认知障碍的严重程度而异,轻度痴呆症的平均WTP最高.
- 诊断的患者平均等待时间在不同情景中从4.7到7.8个月不等,C情景的等待时间最长 (BBM作为确认).
- 场景C和D (涉及BBM作为确认) 预计到2025年,与A和B场景相比,DMT符合条件的患者的累积数量将更高.
结论:
- 实施BBM作为选测试显示了降低诊断等待时间的潜力,特别是在初级保健机构.
- 使用BBM作为确认性测试可以增加符合DMT患者的数量.
- 将BBM整合到诊断途径中可以提高专家能力并降低成本,从而提高获得及时AD治疗的机会.
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