Supplementary Material for: Clinical Characteristics, Health Care Resource Utilization, and Prescription Patterns of Japanese Patients with Physician-Diagnosed Allergic Rhinitis: A Secondary Use of Database Study

Introduction: Allergic rhinitis (AR) is associated with a substantial health care burden. In Japan, clinical patient profiles in real-life settings and evidence on economic burden of AR are limited. We studied clinical characteristics of patients with AR in Japan, and their impact on health care resource utilization (HCRU) and associated costs. Methods: This was a noninterventional study in patients aged ≥2 years with ≥2 physician-diagnosed AR, from a Japanese Claims Database, conducted from 2009 to 2018. The study comprised 6 cohorts; 1 primary, 3 secondary (cohorts 1, 2, 2-s), and 2 comparison cohorts 1 and 2-s (matched surgery and non-surgery). The primary objective was to describe demographic and clinical characteristics of patients in primary cohort. The secondary objectives were assessment of demographic and clinical characteristics in secondary cohorts and comparison of HCRU-related variables and allergic comorbidities between comparison cohorts. Results: Of 5,260,253 subjects data retrieved, 879,348 were included in primary cohort, with demographics and clinical characteristics being consistent across study period. Most frequent AR-related comorbidities were allergic conjunctivitis (41.7%) and asthma (38.6%). By 2018, 4,246 patients were included in secondary cohort 1, 866,453 in secondary cohort 2, 258,855 in secondary cohort 2-s, 3,496 in comparison cohort 1, and 13,984 in comparison cohort 2-s. Monthly HCRU-related variables between comparison cohort 1 and comparison 2-s indicated that AR-related surgeries and prescriptions peaked in prepollen and pollen seasons, respectively. HCRU and related costs were comparable but slightly higher in surgery than in non-surgery cohort. Conclusion: Real-world evidence of patients with AR highlights the need for cost-effective health care with opportunities for developing novel therapies.引言：过敏性鼻炎（Allergic rhinitis, AR）可造成沉重的医疗负担。在日本，真实世界中AR患者的临床特征数据，以及AR经济负担相关的循证证据均较为匮乏。本研究旨在分析日本AR患者的临床特征，并探讨其对医疗资源利用（health care resource utilization, HCRU）及相关医疗成本的影响。 方法：本研究为一项非干预性研究，数据来源于日本医保索赔数据库，纳入2009年至2018年间年龄≥2岁、经医师确诊为AR且确诊次数≥2次的患者。本研究共设置6个队列：1个主队列、3个亚队列（队列1、队列2、队列2-s）以及2个对照队列（队列1与队列2-s，分别匹配手术组与非手术组）。本研究的主要研究目标为描述主队列患者的人口统计学特征与临床特征；次要研究目标为评估亚队列患者的人口统计学与临床特征，并对比对照队列间与HCRU相关的变量及过敏共病情况。 结果：本次共检索到5,260,253名受试者的相关数据，其中879,348名被纳入主队列，研究期间该队列患者的人口统计学与临床特征均保持稳定。最常见的AR相关共病为变应性结膜炎（41.7%）与哮喘（38.6%）。截至2018年，亚队列1共纳入患者4,246名，亚队列2纳入866,453名，亚队列2-s纳入258,855名，对照队列1纳入3,496名，对照队列2-s纳入13,984名。对照队列1与对照队列2-s的月度HCRU相关变量数据显示，AR相关手术量与处方量分别在花粉季前及花粉季达到峰值。手术队列的HCRU及相关成本与非手术队列基本相当，但略高于非手术队列。 结论：AR患者的真实世界研究证据凸显了开发成本效益型医疗方案的必要性，同时也为新型治疗手段的研发提供了潜在方向。