法国睡眠呼吸暂停夜间治疗装置处方的10年全国性分析

文献信息

中文摘要

背景： 鉴于睡眠呼吸暂停在普通人群中的患病率不断上升，且持续气道正压（PAP）和下颌前移装置（MAD）是主要治疗手段，该病已成为日益重要的待解决问题。本研究旨在描述过去十年间法国PAP和MAD处方的演变、相关医疗费用以及受益人和处方者特征的变化。
方法： 本研究基于2014年至2023年间国家医疗保健系统的开放获取报销数据（Open LPP），该数据提供了法国人群中所有PAP和MAD处方的信息。
结果： PAP处方数量平均每年增加16%，从2014年的986,784张上升至2023年的3,362,040张。尽管报销比例有所降低，医疗支出仍翻了一番，2023年PAP相关支出达到9.34亿欧元。私立专科医生对处方增长的贡献最大。在受益人方面，2023年64%的处方为男性患者，而2014年为70%。与此同时，PAP治疗依从性有所下降，2018年67.6%的患者依从性>4小时/天，而2023年为63.6%（p=0.03）。法国MAD处方从2014年的8,110张增加至2023年的29,546张，年均增长17%。
结论： 过去十年间，法国PAP和MAD处方显著增加，同时医疗支出不断上升，处方者和受益人模式也发生了变化。

英文摘要

BACKGROUND: Sleep apnea has become an increasingly important condition to address, given its growing prevalence in the general population with positive airway pressure (PAP) and mandibular advance device (MAD) as the main treatment. This study aims to describe the evolution of PAP and MAD prescriptions in France over the past ten years, the associated healthcare costs, and the changing characteristics of both beneficiaries and prescribers.
METHODS: This study is based on open access reimbursement data from the national health care system (Open LPP) between 2014 and 2023, which provide data on all PAP and MAD prescriptions within the French population.
RESULTS: The number of PAP prescriptions has increased by an average of 16% per year, rising from 986,784 in 2014 to 3,362,040 in 2023. Despite reductions in reimbursement rates, healthcare expenditures have doubled, reaching 934 million euros in 2023 for PAP. Private care specialists contributed the most to the increase in prescriptions. Regarding beneficiaries, 64% of prescriptions in 2023 were for male patients compared to 70% in 2014. Meanwhile, adherence to PAP therapy have decreased with 67.6% of patients having an adherence > 4 h/day in 2018 vs. 63.6% (p = 0.03). MAD prescriptions in France increased from 8,110 in 2014 to 29,546 in 2023, representing an average annual growth of 17%.
CONCLUSION: PAP and MAD prescriptions have risen markedly over the past decade in France, alongside increasing healthcare expenditures and shifting patterns of prescribers and beneficiaries.