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Hong Y, Chen X, Li Z, Zhang X, Zhou C, Wang Y, Wang G, Wu W, Zhou D, Feng Li H. A lifetime economic research of universal HLA-B*58:01 genotyping or febuxostat initiation therapy in Chinese gout patients with mild to moderate chronic kidney disease. Pharmacogenet Genomics 2023; 33:24-34. [PMID: 36729770 DOI: 10.1097/fpc.0000000000000488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate Chinese long-term economic impact of universal human leukocyte antigen B (HLA-B)*58:01 genotyping-guided urate-lowering therapy or febuxostat initiation therapy for gout patients with mild to moderate chronic kidney disease (CKD) from perspective of healthcare system. METHODS A Markov model embedded in a decision tree was structured including four mutually exclusive health states (uncontrolled-on-therapy, controlled-on-therapy, uncontrolled-off-therapy, and death). Mainly based on Chinese real-world data, the incremental costs per quality-adjusted life years (QALYs) gained were evaluated from three groups (universal HLA-B*58:01 testing strategy, and no genotyping prior to allopurinol or febuxostat initiation therapy) at 25-year time horizon. All costs were adjusted to 2021 levels based on Chinese Consumer Price Index and were discounted by 5% annually. One-way and probability sensitivity analysis were performed. RESULTS Among these three groups, universal HLA-B*58:01 genotyping was the most cost-effective strategy in base-case analysis according to Chinese average willingness-to-pay threshold of $37 654.50 per QALY. The based incremental cost-effectiveness ratio was $31784.55 per QALY, associated with 0.046 additional QALYs and $1463.81 increment costs per patient at a 25-year time horizon compared with no genotyping prior to allopurinol initiation strategy. Sensitivity analysis showed 64.3% robustness of these results. CONCLUSION From Chinese perspective of healthcare system, HLA-B*58:01 genotyping strategy was cost-effective for gout patients with mild to moderate CKD in mainland China, especially in the most developed area, such as Beijing and Shanghai. Therefore, we suggest China's health authorities choose the genotyping strategy and make different recommendations according to the differences of local conditions.
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Affiliation(s)
- Yuan Hong
- Department of Pharmacy, Wuxi Children's Hospital
| | - Xichuang Chen
- Department of Pharmacy, Wuxi 9th People's Hospital affiliated to Soochow University and Wuxi Orthopaedic Hospital, Wuxi, Jiangsu
| | - Zhiping Li
- Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai
| | - Xiaoyan Zhang
- Department of Pharmacy, Wuxi 9th People's Hospital affiliated to Soochow University and Wuxi Orthopaedic Hospital, Wuxi, Jiangsu
| | - Cong Zhou
- Department of Pharmacy, Wuxi 9th People's Hospital affiliated to Soochow University and Wuxi Orthopaedic Hospital, Wuxi, Jiangsu
| | - Yan Wang
- Department of Pharmacy, Wuxi Children's Hospital
| | - Guangfei Wang
- Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai
| | - Wei Wu
- Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai
| | - Danli Zhou
- Department of Pharmacy, Wuxi Children's Hospital
| | - Hai Feng Li
- Department of Joint Surgery, Wuxi 9th People's Hospital Affiliated to Soochow University and Wuxi Orthopaedic Hospital, Wuxi, Jiangsu, China
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Yang W, Luo Y, Wu S, Niu X, Yan Y, Qiao C, Ming W, Zhang Y, Wang H, Chen D, Qi M, Ke L, Wang Y, Li L, Li S, Zeng Q. Estimated Annual Economic Burden of Dry Eye Disease Based on a Multi-Center Analysis in China: A Retrospective Study. Front Med (Lausanne) 2021; 8:771352. [PMID: 34926513 PMCID: PMC8673084 DOI: 10.3389/fmed.2021.771352] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/31/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To conduct a multi-center analysis and assess the economic burden due to dry eye disease (DED) in China. Design: A retrospective and cross-sectional study. Methods: Patients (n = 598) with diagnosed DED were recruited from 3 eye centers (in central, southeast, and northeast China) from 1 January 2018 to 31 December 2018. Data were collected regarding the examination, pharmacological therapy, and non-pharmacological therapy fees. Sub-group analyses were stratified by eye center, DED severity, types of DED, number of visits to physicians, and residential area. A logistic regression analysis was conducted to investigate the variables influencing total costs. Results: The per capita costs devoted to DED at the 3 centers were 422.6, 391.3, and 265.4 USD, respectively. The costs of non-pharmacological therapy accounted the largest part in three centers (75.6, 76.4, 76.5%, respectively). Patients with severe DED sustained the largest economic burden. Patients with mixed type of DED spent the most comparing to patients with either evaporative or aqueous-deficient types of DED. Patients spent more during the first visit compared with subsequent visits. Patients living in urban areas spent significantly more than did those living in rural areas (P = 0.001). The logistics regression analysis showed that total costs were significantly influenced by DED severity, number of visits to physicians, and area of residence (beta = 2.83, 0.83, 1.48; P < 0.0001). Conclusions: DED is a chronic ocular disease that timely non-cost counseling, early diagnosis, and efficacious treatment can reduce its economic burden on patients and the society.
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Affiliation(s)
- Wanju Yang
- Aier Eye Hospital of Wuhan University, Wuhan, China
| | - Yanzhu Luo
- Aier Eye Hospital of Wuhan University, Wuhan, China.,Aier School of Ophthalmology, Central South University, Changsha, China.,Department of Cornea and Ocular Surface Diseases, Wuhan Aier Hankou Eye Hospital, Wuhan, China
| | - Shangcao Wu
- Aier Eye Hospital of Wuhan University, Wuhan, China
| | - Xiaoxia Niu
- Department of Cornea and Ocular Surface Diseases, Harbin Aier Eye Hospital, Harbin, China
| | - Yanshuang Yan
- Department of Cornea and Ocular Surface Diseases, Guangzhou Aier Eye Hospital, Guangzhou, China
| | - Chen Qiao
- Aier Eye Hospital of Wuhan University, Wuhan, China.,Department of Cornea and Ocular Surface Diseases, Wuhan Aier Hankou Eye Hospital, Wuhan, China
| | - Wei Ming
- Aier Eye Hospital of Wuhan University, Wuhan, China.,Department of Cornea and Ocular Surface Diseases, Wuhan Aier Hankou Eye Hospital, Wuhan, China
| | - Ying Zhang
- Aier Eye Hospital of Wuhan University, Wuhan, China
| | - Haoyu Wang
- Aier Eye Hospital of Wuhan University, Wuhan, China.,Department of Cornea and Ocular Surface Diseases, Wuhan Aier Hankou Eye Hospital, Wuhan, China
| | - Dan Chen
- Aier Eye Hospital of Wuhan University, Wuhan, China.,Department of Cornea and Ocular Surface Diseases, Wuhan Aier Hankou Eye Hospital, Wuhan, China
| | - Mengying Qi
- Aier Eye Hospital of Wuhan University, Wuhan, China.,Department of Cornea and Ocular Surface Diseases, Wuhan Aier Hankou Eye Hospital, Wuhan, China
| | - Lan Ke
- Aier Eye Hospital of Wuhan University, Wuhan, China.,Department of Cornea and Ocular Surface Diseases, Wuhan Aier Hankou Eye Hospital, Wuhan, China
| | - Ying Wang
- Aier Eye Hospital of Wuhan University, Wuhan, China.,Department of Cornea and Ocular Surface Diseases, Wuhan Aier Hankou Eye Hospital, Wuhan, China
| | - Liping Li
- Aier Eye Hospital of Wuhan University, Wuhan, China.,Department of Cornea and Ocular Surface Diseases, Wuhan Aier Hankou Eye Hospital, Wuhan, China
| | | | - Qingyan Zeng
- Aier Eye Hospital of Wuhan University, Wuhan, China.,Aier School of Ophthalmology, Central South University, Changsha, China.,Department of Cornea and Ocular Surface Diseases, Wuhan Aier Hankou Eye Hospital, Wuhan, China.,Aier Cornea Institute, Beijing, China.,Aier School of Ophthalmology and Optometry, Hubei University of Science and Technology, Xianning, China
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Miyamoto ST, Valim V, Fisher BA. Health-related quality of life and costs in Sjögren's syndrome. Rheumatology (Oxford) 2019; 60:2588-2601. [PMID: 30770918 DOI: 10.1093/rheumatology/key370] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 10/13/2018] [Indexed: 02/06/2023] Open
Abstract
Health-related quality of life (HRQoL) has an increasing role in medical decision-making. This review of the literature aims to provide an overview on HRQoL, costs, and work disability in SS, a disease characterized by focal lymphocytic infiltration of exocrine glands with no therapeutics of proven immunomodulatory potential. HRQoL is markedly reduced in SS in multiple studies across many countries when compared with HRQoL in healthy controls. The reduction in HRQoL is similar to that observed in other chronic diseases such as RA, SLE, FM and, interestingly, non-SS sicca syndrome. Impaired HRQoL in SS has been found to be associated with fatigue, pain/articular involvement, ocular and oral involvement, pruritus, sexual dysfunction, impaired sleep, pulmonary manifestations, psychological dysfunction and impaired physical function. Until now, no therapeutic has been shown to improve HRQoL in an adequately powered double-blind, placebo-controlled randomized controlled trial. Although primary SS does not, in general, impair life expectancy and is often inappropriately considered a benign 'nuisanvce' disease for those patients without systemic manifestations, the associated costs and work disability are striking. This, together with the significant reduction in HRQoL, strongly argues for the development of new therapeutic approaches to manage this neglected disease.
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Affiliation(s)
- Samira T Miyamoto
- Department of Integrated Education in Health, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Valéria Valim
- Department of Medical Clinic, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Benjamin A Fisher
- National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK.,Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,Rheumatology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Li Z, Fu T, Li L, Cui Y, Dong C, Li J, Gu Z. Prevalence, severity, and predictors of dry eye and dry mouth in Chinese patients with primary Sjögren syndrome. Clin Rheumatol 2018; 37:2971-2979. [PMID: 30094749 DOI: 10.1007/s10067-018-4233-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/23/2018] [Accepted: 07/23/2018] [Indexed: 02/08/2023]
Abstract
Dry eye and dry mouth are typical clinical symptoms of primary Sjögren's syndrome (pSS), yet not considered in the assessment of severity and predictors in China. This study aimed to investigate the prevalence, severity, and potential predictors of dry eye/dry mouth among Chinese pSS patients. A cross-sectional study was conducted from the Affiliated Hospital of Nantong University. A series of questionnaires were applied: Ocular Surface Disease Index (OSDI), EULAR Sjogren's Syndrome Patient Reported Index (ESSPRI)-dry mouth items, fatigue severity scale (FSS), the 10 cm visual analog scale (VAS). Laboratory examinations were taken to obtain some biochemical indicators (i.e., C-reactive protein, erythrocyte sedimentation rate, anti-SSA/SSB antibody). Stepwise logistic/linear regression model was used to investigate the potential predictors of dry eye/dry mouth, respectively. Statistical analysis was performed using SPSS version 20.0. Two hundred twenty-four pSS patients were included in this study. Among them, 215 (95.98%) patients reported ESSPRI-dry mouth items score > 0, and the mean score was 4.92 ± 2.43. In addition, according to the score of OSDI, 84 (37.5%) subjects reported non-dry eye, whereas 140 (62.5%) subjects reported dry eye (44 mild, 31 moderate, 65 severe), and the mean of the total OSDI score was 25.01 ± 23.58. Then, using logistic regression and linear regression respectively, we found that age and fatigue were the potential predictors of dry eye, whereas dry mouth was predicted by age, fatigue, total pain, and ESR. The results of this study suggested that rheumatologists should pay attention to pSS patients' dry eye and dry mouth, especially those with older age, higher level of ESR, more severe fatigue, and pain.
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Affiliation(s)
- Zhenyu Li
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China.,School of Nursing, Nantong University, 19th Qixiu Road, Nantong, 226001, China
| | - Ting Fu
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China
| | - Lin Li
- School of Nursing, Nantong University, 19th Qixiu Road, Nantong, 226001, China
| | - Yafei Cui
- School of Nursing, Nantong University, 19th Qixiu Road, Nantong, 226001, China
| | - Chen Dong
- School of Nursing, Nantong University, 19th Qixiu Road, Nantong, 226001, China
| | - Jing Li
- Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China.
| | - Zhifeng Gu
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China. .,Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China.
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