Implementing standardized cost categories within economic evaluations in musculoskeletal diseases

Abstract

We present a matrix of relevant resource utilization domains for use in standardizing applied cost assessment in musculoskeletal conditions. In addition,we highlight the importance of selecting cost categories during the development of an economic evaluation. A set of four steps was applied: (a) literature search identifying economic evaluations in osteoarthritis and osteoporosis, (b) listing and aggregation of cost categories mentioned in the identified articles, (c) development of a matrix of resource utilization domains, and (d) qualitative discussion regarding the generalizability of the matrix to other musculoskeletal conditions such as rheumatoid arthritis. We examined 41 full-length articles (25 cost-of-illness studies or cost-comparisons, 14 cost-effectiveness analyses, and 2 cost-utility analyses), of which 16 studies focused on osteoarthritis and 25 on osteoporosis. The reviewed studies used a total of 151 different cost categories which, after adjustment for synonymous labeling, made up 34 cost categories. A matrix of 16 separate resource utilization domains was developed including seven outpatient, three inpatient, four other disease-related, and two productivity cost domains. We found that cost assessment in economic evaluation in the key musculo-skeletal diseases (osteoarthritis, osteoporosis, and rheumatoid arthritis) is performed rather inhomogeneously. A generalized matrix of applicable resource utilization domains and a flowchart facilitating the development of appropriate resource utilization data have been developed.

Indirect cost assessment in patients with rheumatoid arthritis (RA): Comparison of data from the health economic patient questionnaire HEQ‐RA and insurance claims data

“…It has become obvious that patients tend to underestimate the length and number of sick leave periods due to RA (3). In the present investigation, the major reason for this underestimation is sick leave cases not mentioned by the patients.…”

“…Current economic evaluations in the field of rheumatic diseases underline the need to include economic data in outcome assessment of clinical trials on rheumatoid arthritis (RA) and other musculoskeletal disorders (1)(2)(3). Since many evolving new therapies, such as biologic therapies, are costly, it is important to capture not only clinical data but additionally data on costs and their changes under therapy in order to render information on health economic effectiveness (1).…”

Indirect costs in patients with coronary artery disease and mental disorders: A systematic review and meta-analysis

“…The human capital method measures indirect costs as the loss in productivity due to sickness of the employee. The friction cost method estimates the amount of production lost, as long as the referred to the loss of working hours due to absence from the workplace, delayed return to work and impaired productivity [4,16,17]. The present review focuses on indirect costs in CAD patients with comorbid mental disorders compared to CAD patients without mental comorbidity.…”

Konzeptionelle und methodische Grundlagen von Krankheitskostenerhebungen in der Rheumatologie

“…Basierend auf den Ergebnissen dieses Projektes werden in der folgenden Übersicht wichtige konzeptionelle und methodische Grundlagen der Krankheitskostenanalyse bei rheumatischen Krankheiten dargestellt. Die Darstellung folgt dabei dem vorgeschlagenen ,Flussdiagramm für Kostenanalysen' ( [12], Abb. 1) und berücksichtigt die Bereiche i) Auswahl relevanter Kostendomänen, ii) Definition des Aggregationsniveaus, iii) Identifikation der Kostendatenquelle(n), iv) Datenerhebung und v) Datenanalyse.…”