Thoughts on health economics in rheumatoid arthritis

Kobelt, Gisela

doi:10.1136/ard.2007.078964

Cited by 18 publications

(13 citation statements)

References 22 publications

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“…The relatively small differences in the proportion of social security of the gross domestic product in the study countries [36] does not explain the observed differences in the proportions and economic effects of retirement found in this study. In Italy, a high proportion of social security expenses is used for pensions [37], though the statistics do not indicate the proportion of pensions arising from early retirement due to sickness or to specific diseases, such as RA. In general, national statistics do not reveal how the social security expenses are divided within the population, and the differences in the structure of the social security systems may have considerable effect on the figures reported in this analysis [6,20].…”

Section: Discussionmentioning

confidence: 99%

Influence of rheumatoid arthritis-related morning stiffness on productivity at work: results from a survey in 11 European countries

2015

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The objective of this study was to evaluate the influence of morning stiffness on productivity at work and to estimate the work-related economic consequences of morning stiffness among patients with RA-related morning stiffness in 11 European countries. The original sample comprised 1061 RA patients from 11 European countries (Belgium, Denmark, Finland, France, Germany, Italy, Norway, Poland, Spain, Sweden and UK). They had been diagnosed with RA and experience morning stiffness three or more times per week. Data were collected by interviews. Women comprised 77.9 % of the sample, the average age was 50.4 years, and 84.3 % had RA diagnosed for more than 2 years. Overall costs of RA-related morning stiffness was calculated to be 27,712€ per patient per year, varying from 4965€ in Spain to 66,706€ in Norway. On average, 96 % of the overall production losses were attributed to early retirement, with a markedly lower level (77 %) in Italy than in other countries (p < 0.0001). The proportion of patients who reported retirement due to morning stiffness and productivity losses due to late work arrivals and working while sick showed considerable variation across the countries represented in the study. Overall, the average annual cost of late arrivals (0.8 % of the total costs) was approximately half of the costs attributed to sick leave (1.7 %) and working while sick (1.5 %). Morning stiffness due to RA causes significant production losses and is a significant cost burden throughout Europe. There seem to be notable differences in the impact of morning stiffness on productivity between European countries.

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Section: Discussionmentioning

confidence: 99%

Influence of rheumatoid arthritis-related morning stiffness on productivity at work: results from a survey in 11 European countries

2015

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“…Comparison with other studies is challenging because the health care system organization varies among countries, different perspectives are used (societal or public payer perspective), and study inclusion criteria may differ (early or established arthritis, hospital or private practice patients) (42)(43)(44). Two French studies estimated indirect costs; both were cross-sectional studies of established RA patients.…”

Section: Discussionmentioning

confidence: 99%

Work Productivity Loss in Early Arthritis During the First 3 Years of Disease: A Study From a French National Multicenter Cohort

Dadoun

Guillemin

Lucier³

et al. 2014

Arthritis Care & Research

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Objective. To assess work productivity (WP) loss during the first 3 years of disease in a cohort of patients with early arthritis (EA) diagnosed between 2002 and 2005. Methods. The ESPOIR (Etude et Suivi des Polyarthrites Indifférenciées Récentes) cohort included 813 EA patients; we included those of working age at baseline in the present study. WP loss was assessed by 3 components: sick leave, permanent disability, and early retirement. The proportion of affected patients and the mean number of days off work were assessed for each component. WP costs were estimated and determinants of positive and extreme costs were assessed by logistic regression models. Results. Among the 664 patients included, 81.6% were in the workforce at baseline. During the first 3 years of disease, 45% reported at least 1 sick leave day and 11% reported permanent disability. Only a few patients (1%) reported early retirement. The mean number of days on sick leave due to EA decreased regularly from 44 to 13, whereas the mean number of days on permanent disability tripled from 10 to 33. The mean annual cost was €1,333 (95% confidence interval €1,075-1,620). Sick leave longer than 30 days due to EA before inclusion and a decrease in mental and physical scores of the Medical Outcomes Study Short Form 36 at inclusion were independent determinants of positive and extreme costs in multivariate models. Conclusion. WP loss is substantial in EA patients and is due to permanent disability before the third year of disease. Work absence and poor mental and physical health status at baseline are major determinants of WP costs.

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“…However, these therapies are associated with very high drug costs and a high incremental cost-effectiveness ratio compared to conventional DMARDs [10,11]. Expensive treatments could be widely available if their cost-effectiveness for public reimbursement is justified [12]. Cost-utility analysis in reimbursement dossiers applies the quality-adjusted life year (QALY) as the health benefit outcome [13].…”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life and utility in patients receiving biological and non-biological treatments in rheumatoid arthritis

Inotai

Rojkovich²,

Fülöp³

et al. 2011

Rheumatol Int

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Biological treatments earn increasing significance in the treatment of rheumatoid arthritis (RA) but are associated with high incremental cost-effectiveness ratio compared to conventional antirheumatic treatments such as disease-modifying antirheumatic drugs. As the most important objective of medical technologies should be to increase life years and/or patients' health-related quality of life (HRQoL), measuring QoL and utility in RA patients treated with biological therapies is crucial. The objective of this study is to compare the utility and QoL of patients treated with biological (n = 85) and non-biological (n = 168) antirheumatic drugs in Hungary in a cross-sectional non-interventional study. A measure of impairment (Disease Activity Score (DAS)-28), QoL measure (EuroQol five Dimension (EQ-5D) Visual Analogue Scale (VAS), Rheumatoid Arthritis Quality of Life (RAQoL)) and utility measures (indirect: EQ-5D index, direct: time trade-off (TTO)) were applied using an interview method. The Pearson correlation was used to assess the strength of the relationship of different measures in the total study group (n = 253). The EQ-5D index (biological treatment: 0.608, non-biological treatment: 0.483; P = 0.012) and DAS-28 (biological treatment: 3.8, non-biological treatment: 4.5; P = 0.003) showed statistically significant difference between the two subcohorts after adjusting data by age, gender and disease duration. Our results indicate that patients on biological treatment have lower disease activity and higher utility; however, it was not statistically significant in all cases. According to our knowledge, TTO was not used previously in Hungarian RA patients. Utility data concerning biological treatments are essential for cost-utility models in health technology assessment reports for public reimbursement.

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Thoughts on health economics in rheumatoid arthritis

Cited by 18 publications

References 22 publications

Influence of rheumatoid arthritis-related morning stiffness on productivity at work: results from a survey in 11 European countries

Influence of rheumatoid arthritis-related morning stiffness on productivity at work: results from a survey in 11 European countries

Work Productivity Loss in Early Arthritis During the First 3 Years of Disease: A Study From a French National Multicenter Cohort

Health-related quality of life and utility in patients receiving biological and non-biological treatments in rheumatoid arthritis

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