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Effects of Primary Biliary Cholangitis on Quality of Life and Health Care Costs in the United Kingdom.
Rice, Stephen; Albani, Viviana; Minos, Dimitrios; Fattakhova, Gulnar; Mells, George F; Carbone, Marco; Flack, Steven; Varvaropoulou, Nikoletta; Badrock, Jonathan; Spicer, Ann; Sandford, Richard N; Shirley, Mark D F; Coughlan, Diarmuid; Hirschfield, Gideon; Taylor-Robinson, Simon D; Vale, Luke; Jones, David E J.
Afiliação
  • Rice S; Health Economics Group, Institute of Health and Society, Newcastle University, Newcastle upon Tyne. Electronic address: stephen.rice@ncl.ac.uk.
  • Albani V; Health Economics Group, Institute of Health and Society, Newcastle University, Newcastle upon Tyne.
  • Minos D; Department of Political Economy, King's College London, London.
  • Fattakhova G; Health Economics Group, Institute of Health and Society, Newcastle University, Newcastle upon Tyne.
  • Mells GF; Department of Medical Genetics, Cambridge Biomedical Campus, University of Cambridge, Cambridge.
  • Carbone M; Department of Medical Genetics, Cambridge Biomedical Campus, University of Cambridge, Cambridge.
  • Flack S; Department of Medical Genetics, Cambridge Biomedical Campus, University of Cambridge, Cambridge.
  • Varvaropoulou N; Department of Medical Genetics, Cambridge Biomedical Campus, University of Cambridge, Cambridge.
  • Badrock J; Department of Medical Genetics, Cambridge Biomedical Campus, University of Cambridge, Cambridge.
  • Spicer A; Department of Medical Genetics, Cambridge Biomedical Campus, University of Cambridge, Cambridge.
  • Sandford RN; Department of Medical Genetics, Cambridge Biomedical Campus, University of Cambridge, Cambridge.
  • Shirley MDF; School of Biology, Newcastle University, Newcastle upon Tyne.
  • Coughlan D; Health Economics Group, Institute of Health and Society, Newcastle University, Newcastle upon Tyne.
  • Hirschfield G; Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham; Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Canada.
  • Taylor-Robinson SD; Department of Surgery & Cancer, Imperial College London, London.
  • Vale L; Health Economics Group, Institute of Health and Society, Newcastle University, Newcastle upon Tyne.
  • Jones DEJ; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
Clin Gastroenterol Hepatol ; 19(4): 768-776.e10, 2021 04.
Article em En | MEDLINE | ID: mdl-32562892
ABSTRACT
BACKGROUND &

AIMS:

There have been few high-quality studies of the costs, preference-based health-related quality of life (HRQoL) and cost effectiveness of treatments for primary biliary cholangitis (PBC). We aimed to estimate the marginal effects of PBC complications and symptoms, accounting for treatment, on HRQoL and the annual cost of health care in the United Kingdom (UK). These are essential components for evaluation of cost effectiveness and this information will aid in evaluation of new treatments.

METHODS:

Questionnaires were mailed to 4583 participants in the UK-PBC research cohort and data were collected on HRQoL and use of the National Health Service (NHS) in the UK from 2015 through 2016. HRQoL was measured using the EQ-5D-5L instrument. The annual cost of resource use was calculated using unit costs obtained from NHS sources. We performed econometric analyses to determine the effects of treatment, symptoms, complications, liver transplantation status, and patient characteristics on HRQoL and annual costs.

RESULTS:

In an analysis of data from 2240 participants (over 10% of all UK PBC patients), we found that PBC symptoms have a considerable effect on HRQoL. Ursodeoxycholic acid therapy was associated with significantly higher HRQoL regardless of response status. Having had a liver transplant and ascites were also independently associated with reduced HRQoL. Having had a liver transplant (US$4294) and esophageal varices (US$3401) were the factors with the two greatest mean annual costs to the NHS. Symptoms were not independently associated with cost but were associated with reduction in HRQoL for patients, indicating the lack of effective treatments for PBC symptoms.

CONCLUSIONS:

In an analysis of data from 2240 participants in the UK PBC, we found that HRQoL and cost estimates provide greater insight into the relative importance of PBC-related symptoms and complications. These findings provide estimates for health technology assessments of new treatments for PBC.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Qualidade de Vida / Cirrose Hepática Biliar Tipo de estudo: Health_economic_evaluation / Health_technology_assessment Limite: Humans País/Região como assunto: Europa Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Qualidade de Vida / Cirrose Hepática Biliar Tipo de estudo: Health_economic_evaluation / Health_technology_assessment Limite: Humans País/Região como assunto: Europa Idioma: En Ano de publicação: 2021 Tipo de documento: Article