Evolution of cost structures in rheumatoid arthritis over the past decade

Abstract

ObjectiveTo estimate the changes in direct and indirect costs induced by patients with rheumatoid arthritis (RA) in German rheumatology, between 2002 and 2011. To examine the impact of functional status on various cost domains. To compare the direct costs incurred by patients at working age (18–64 years) to patients at an age of retirement (≥65 years).MethodsWe analysed data from the National Database of the German Collaborative Arthritis Centres with about 3400 patients each year. Costs were calculated using fixed prices as well as annually updated cost factors. Indirect costs were calculated using the human capital as well as the friction cost approaches.ResultsThere was a considerable increase in direct costs: from €4914 to €8206 in patients aged 18–64, and from €4100 to €6221 in those aged ≥65, attributable to increasing prescription of biologic agents (18–64 years from 5.6% to 31.2%, ≥65 years from 2.8% to 19.2%). This was accompanied by decreasing inpatient treatment expenses and indirect costs due to sick leave and work disability. The total growth of cost, on average, was €2437–2981 for patients at working age, and €2121 for patients at retirement age.ConclusionsThe increase in treatment costs for RA over the last decade was associated with lower hospitalisation rates, better functional status and a lower incidence of work disability, offsetting a large proportion of risen drug costs. Since the rise in drug costs has manifested a plateau from 2009 onwards, no relevant further increase in total costs for patients with RA treated in German rheumatology is expected.

Effectiveness of an integrated care intervention on supervisor support and work functioning of workers with rheumatoid arthritis

“…We measured the quality of life with the RAND 36. [38,39] All nine subscales of the RAND 36 were included in the questionnaire (mental health (1), pain (2), physical role limitations (3), physical functioning (4), social functioning (5), vitality (6), emotional role limitations (7), general health perception (8) and perceived health change (9). We furthermore included baseline data of all of the outcomes described above as potential confounders.…”

“…[5][6][7] Despite a slight decrease in work disability (permanent exclusion from work) rates over the past decade, permanent work disability still occurs frequently. [8] At-work productivity loss implies that a person is present at work, but is limited in meeting work demands. Besides at-work productivity loss, work instability is also an important concept for patients who are still working.…”

Long-term trends in rheumatology care

“…international publications have emerged from the data. Key findings include trend analyses of care and burden of diseases [5][6][7][8], employment and cost analyses [9][10][11][12][13].…”

Comparing Generic Drug Markets in Europe and the United States: Prices, Volumes, and Spending

“…R ising drug prices are putting pressure on health care budgets . Drugs account for sizable shares of health care spending in rich countries, with costs of new treatments for diabetes, multiple sclerosis, rheumatoid arthritis, various cancers, and dermatological conditions increasing. There are many reasons, including aggressive pricing strategies by manufacturers and adoption of greater numbers of orphan and personalized drugs with high price tags .…”