Improving rheumatoid arthritis management within the Spanish National Health System: a social return on investment study

Abstract

ObjectiveTo define a set of proposals that would improve the current management of patients with rheumatoid arthritis (RA) within the Spanish National Health System (SNHS), and to estimate the impact of their implementation from a social perspective. Methods A one-year forecast-type Social Return on Investment (SROI) analysis was performed on the basis of information collected from a scientific literature review, official data, and multiple stakeholders regarding RA. A sub-analysis was performed within the areas of diagnosis, early RA (<2 years from diagnosis), and established RA (≥2 years from diagnosis). Results Stakeholders agreed on a set of 22 proposals, which included incorporating specialised nursing, addressing adherence issues, providing psychological support, or promoting the role of patient associations, among others.Their implementation would require an investment of 289 million euros and yield a social return of 913 million euros, i.e. a social return of 3.16 euros per euro invested (2.92 euros in the worst-case scenario and 3.40 euros in the best-case scenario). The greatest social return relative to investment and the greatest attributed to intangible aspects were observed within the area of early RA. ConclusionEvidence-based recommendations for the management of RA are aspirational. Nevertheless, the present study estimated that the implementation of the set of proposals would result in a positive impact relative to the investment needed to implement them. The results may guide management decisions to reduce the burden associated with RA, and help bridge the gap between evidence-based recommendations and routine clinical practice.

A Social Return on Investment Analysis of Improving the Management of Chronic Obstructive Pulmonary Disease Within the Spanish National Healthcare System

“… 19 Despite the subjectivity associated with some of these methods, valuing intangible aspects without a market price is essential to expose social returns, usually associated with patient and caregiver needs, which would otherwise remain unaccounted for. Previous experiences have been used to guide decisions relative to healthcare interventions, 18 , 20–23 including interventions on chronic diseases overall, 24 heart failure, 25 psoriasis, 26 multiple sclerosis, 27 rheumatoid arthritis, 28 or haemophilia A, 29 among others. To date, no other study has used the SROI method to assess the impact of any healthcare intervention specifically designed for COPD.…”

Optimising the management of patients with multiple myeloma in Spain: A measurement of the social return on investment

“…The SROI method has been previously used in the area of oncology (de Castro Carpeño et al, 2018; Laing & Moules, 2016) and other health‐related areas such as pulmonology (Merino, Lorenzo, et al, 2022), haematology (Soto et al, 2022), cardiology (Merino et al, 2020; Piñeiro et al, 2015), nephrology (Lophongpanit et al, 2019), neurology (Jones et al, 2014; Moral Torres et al, 2020; Willis et al, 2018), dermatology (Carretero et al, 2020), rheumatology (Merino, Ivanova, et al, 2022), ageing (Jones et al, 2015; Scharlach, 2015) or maternity (Banke‐Thomas et al, 2017; Goudet et al, 2018), among others (Banke‐Thomas et al, 2015; Masters et al, 2017). However, we are unaware of any study on the impact of MM management using the SROI method.…”