Cost of Illness, Quality of Life, and Work Outcomes in Active Ankylosing Spondylitis Patients Treated With Adalimumab in China

Abstract

Objectives: To access the cost of illness, quality of life and work limitation in active ankylosing spondylitis (AS) patients using adalimumab in China.Methods: A prospective study was performed in 91 patients with active AS in China. Adult patients (aged ≥ 18 years) fulfilled the 1984 New York modified criteria of AS with the Bath Ankylosing Spondylitis Disease Activity Index ≥ 4 were enrolled. All participants received adalimumab (40 mg per 2 weeks) therapy and completed questionnaires about disease characteristics, quality of life and cost. Only patients with pay-work completed the Work Limitation Questionnaire and Work productivity and activity impairment questionnaire in AS. Factors associated with work outcomes were evaluated.Results: A total of 91 patients with mean age of 30 years old (87.8% males) and mean disease duration of 10 years received adalimumab treatment for 24 weeks. The annual estimated cost of each patient was $37581.41 while the direct cost accounted for 84.6%. Seventy-eight percent of patients have a paid job with average work productivity loss of 0.28 measured by work limitation questionnaire, absenteeism and presenteeism were 10.22 and 43.86%, respectively, with a mean work productivity loss of 47.92% measured by Work productivity and activity impairment questionnaire in AS. Patients experienced significantly greater improvements after adalimumab treatment in presenteeism, absenteeism, work productivity, and quality of life.Conclusions: The cost of AS patients with adalimumab therapy was high in China. Disease activity, physical function, quality of life, and work outcomes improved significantly after therapy.

Effects of Adalimumab Entering National Reimbursement on Medical Costs for Patients With Psoriasis: A 4-Year Single-Center Retrospective Study in China

“…Some studies have shown that the reduction of medical costs helps to improve patient compliance [11][12] and reduce the loss of indirect economic costs and the long-term financial burden. 13 We also found that the proportion of patients with psoriasis using biological agents was low (only 1.11% in the research of this study).The proportion of patients using biological agents in the United States is higher than in China. [14][15] High prices affect the use of biological agents.…”

“…Some studies have shown that the reduction of medical costs helps to improve patient compliance 11-12 and reduce the loss of indirect economic costs and the long-term financial burden. 13…”

Measurement of pre‐treatment inflammatory cytokine levels is valuable for prediction of treatment efficacy to tumor necrosis factor inhibitor in axial spondyloarthritis patients

“…Axial spondyloarthritis (axSpA), a chronic inflammatory disease leading to vertebral and sacroiliac fusion, is characterized by lower back pain and back stiffness in the morning 1–3 . Even though there is still no cure for axSpA patients, the application of tumor necrosis factor‐α (TNF‐α) inhibitor in the treatment of axSpA ameliorates the disease status, including controlling the inflammation, decreasing the disease activity, and improving the health‐related quality of life 4–6 . However, the annual cost of TNF inhibitor is high; in addition, a certain proportion of axSpA patients stop the TNF inhibitor therapy because of the lack of efficacy and the presence of adverse events 7–9 .…”

“…[1][2][3] Even though there is still no cure for axSpA patients, the application of tumor necrosis factorα (TNFα) inhibitor in the treatment of axSpA ameliorates the disease status, including controlling the inflammation, decreasing the disease activity, and improving the health-related quality of life. [4][5][6] However, the annual cost of TNF inhibitor is high; in addition, a certain proportion of axSpA patients stop the TNF inhibitor therapy because of the lack of efficacy and the presence of adverse events. [7][8][9] Hence, it is essential to find biomarkers to predict the TNF inhibitor response in axSpA patients.…”

Global trends and research status in ankylosing spondylitis clinical trials: a bibliometric analysis of the last 20 years

“…Combined with the keyword outbreak analysis, “inflammation,” “risk” and “improvement” have been the emerging keywords in recent years. This indicates that clinicians are now more focused on the long-term quality of life of patients ( 48 – 50 ). Through the superimposed visual analysis of keywords, combined with the analysis of highly cited articles displayed in Table 4 and Table 5 in the past 10 years, it can be predicted that “placebo-controlled trial,” “double-blind,” “infliximab,” “improvement,” and other keywords may still break out in the future.…”