HEALTH RELATED QUALITY OF LIFE AND ECONOMIC BURDEN OF IGA NEPHROPATHY PATIENTS IN CHINA: A CROSS-SECTIONAL STUDY
Author(s)
yanan wu, Ph.D, Shunping Li, Ph.D, lei dou, Ph.D.
Department of Social Medicine and Health Management, School of Public Health, Shandong University, Jinan, China.
Department of Social Medicine and Health Management, School of Public Health, Shandong University, Jinan, China.
OBJECTIVES: This study aimed to quantify the multidimensional disease burden of IgA nephropathy (IgAN) in China, including economic costs and health-related quality of life (HRQoL), and to identify key determinants influencing economic outcomes among IgAN patients.
METHODS: A cross-sectional survey was conducted from June 2023 to May 2024 using snowball sampling to recruit IgAN patients through patient networks. The structured questionnaire captured sociodemographic and clinical characteristics, direct medical costs, direct non-medical costs, productivity losses, and HRQoL assessed by EQ-5D-5L and FACIT-Fatigue scale. Predictor variables were categorized according to Andersen’s Behavioral Model of Health Services Utilization. Generalized linear models with gamma distribution and log-link functions were used for cost analysis, while Shapley value decomposition quantified the relative contribution of variables across cost domains.
RESULTS: Among 323 valid respondents, mean EQ-5D-5L utility score was 0.834 ± 0.160, with anxiety/depression being the most frequently impaired dimension (73.68%). Fatigue symptoms were reported by 74.61% of participants. Mean annual costs comprised direct medical costs of 15,374 CNY/2,163 USD (out-of-pocket: 9,456 CNY/1,330 USD), direct non-medical costs of 3,555 CNY/500 USD, and indirect costs of 10,188 CNY/1,433 USD. Cost burden intensified with health status deterioration, driven primarily by escalating direct medical costs and productivity losses. Shapley value analysis revealed that need factors predominated as determinants of direct medical costs, while propensity characteristics demonstrated superior explanatory power for direct non-medical and indirect cost variations.
CONCLUSIONS: IgA nephropathy imposes considerable multidimensional burden on Chinese patients, manifested through diminished HRQoL and substantial economic impact. The differential influence of Andersen model factors across cost categories underscores the complexity of economic burden. Policymakers should implement comprehensive evaluations and individualized management strategies targeting key determinants to optimize resource allocation and patient outcomes.
METHODS: A cross-sectional survey was conducted from June 2023 to May 2024 using snowball sampling to recruit IgAN patients through patient networks. The structured questionnaire captured sociodemographic and clinical characteristics, direct medical costs, direct non-medical costs, productivity losses, and HRQoL assessed by EQ-5D-5L and FACIT-Fatigue scale. Predictor variables were categorized according to Andersen’s Behavioral Model of Health Services Utilization. Generalized linear models with gamma distribution and log-link functions were used for cost analysis, while Shapley value decomposition quantified the relative contribution of variables across cost domains.
RESULTS: Among 323 valid respondents, mean EQ-5D-5L utility score was 0.834 ± 0.160, with anxiety/depression being the most frequently impaired dimension (73.68%). Fatigue symptoms were reported by 74.61% of participants. Mean annual costs comprised direct medical costs of 15,374 CNY/2,163 USD (out-of-pocket: 9,456 CNY/1,330 USD), direct non-medical costs of 3,555 CNY/500 USD, and indirect costs of 10,188 CNY/1,433 USD. Cost burden intensified with health status deterioration, driven primarily by escalating direct medical costs and productivity losses. Shapley value analysis revealed that need factors predominated as determinants of direct medical costs, while propensity characteristics demonstrated superior explanatory power for direct non-medical and indirect cost variations.
CONCLUSIONS: IgA nephropathy imposes considerable multidimensional burden on Chinese patients, manifested through diminished HRQoL and substantial economic impact. The differential influence of Andersen model factors across cost categories underscores the complexity of economic burden. Policymakers should implement comprehensive evaluations and individualized management strategies targeting key determinants to optimize resource allocation and patient outcomes.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
PCR35
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
SDC: Rare & Orphan Diseases, SDC: Urinary/Kidney Disorders