Profile, Healthcare Resource Consumption and Related Costs in ANCA-Associated Vasculitis Patients: A Real-World Analysis in Italy.
Adv Ther
; 40(12): 5338-5353, 2023 12.
Article
em En
| MEDLINE
| ID: mdl-37787877
ABSTRACT
INTRODUCTION:
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are rare autoimmune diseases triggering inflammation of small vessels. This real-world analysis was focused on the most common AAV forms, granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), to describe patients' demographic and clinical characteristics, therapeutic management, disease progression, and the related economic burden.METHODS:
A retrospective analysis was conducted on administrative databases of a representative sample of Italian healthcare entities, covering approximately 12 million residents. Between January 2010 and December 2020, adult GPA patients were identified by payment waiver code or hospitalization discharge diagnosis, and MPA patients by payment waiver code with or without hospitalization discharge diagnosis. Clinical outcomes were evaluated through AAV-related hospitalizations, renal failure onset, and mortality. Economic analysis included healthcare resource utilization deriving from drugs, hospitalizations, and outpatient specialist services. The related mean direct costs year/patient were also calculated in patients stratified by presence/absence of glucocorticoid therapy and type of inclusion criterion (hospitalization/payment waiver code).RESULTS:
Overall, 859 AAV patients were divided into GPA (n = 713; 83%) and MPA (n = 146; 17%) cohorts. Outcome indicators highlighted a clinically worse phenotype associated with GPA compared to MPA. Cost analysis during follow-up showed tendentially increased expenditures in glucocorticoid-treated patients versus untreated (overall AAV 8728 vs. 7911; GPA 9292 vs. 9143; MPA 5967 vs. 2390), mainly driven by drugs (AAV 2404 vs. 874; GPA 2510 vs. 878; MPA 1881 vs. 854) and hospitalizations.CONCLUSION:
Among AAV forms, GPA resulted in a worse clinical picture, higher mortality, and increased costs. This is the first real-world pharmaco-economic analysis on AAV patients stratified by glucocorticoid use on disease management expenditures. In both GPA and MPA patients, glucocorticoid treatment resulted in higher healthcare costs, mostly attributable to medications, and then hospitalizations, confirming the clinical complexity and economic burden for management of patients with autoimmune diseases under chronic immunosuppression.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos
/
Poliangiite Microscópica
Tipo de estudo:
Health_economic_evaluation
/
Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Humans
Idioma:
En
Revista:
Adv Ther
Assunto da revista:
TERAPEUTICA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Itália