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The Cost of Ankylosing Spondylitis in the UK Using Linked Routine and Patient-Reported Survey Data

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  • Roxanne Cooksey
  • Muhammad J Husain
  • Sinead Brophy
  • Helen Davies
  • Muhammad A Rahman
  • Mark D Atkinson
  • Ceri J Phillips
  • Stefan Siebert

Abstract

Background: Ankylosing spondylitis (AS) is a chronic inflammatory arthritis which typically begins in early adulthood and impacts on healthcare resource utilisation and the ability to work. Previous studies examining the cost of AS have relied on patient-reported questionnaires based on recall. This study uses a combination of patient-reported and linked-routine data to examine the cost of AS in Wales, UK. Methods: Participants in an existing AS cohort study (n = 570) completed questionnaires regarding work status, out-of-pocket expenses, visits to health professionals and disease severity. Participants gave consent for their data to be linked to routine primary and secondary care clinical datasets. Health resource costs were calculated using a bottom-up micro-costing approach. Human capital costs methods were used to estimate work productivity loss costs, particularly relating to work and early retirement. Regression analyses were used to account for age, gender, disease activity. Results: The total cost of AS in the UK is estimated at £19016 per patient per year, calculated to include GP attendance, administration costs and hospital costs derived from routine data records, plus patient-reported non-NHS costs, out-of-pocket AS-related expenses, early retirement, absenteeism, presenteeism and unpaid assistance costs. The majority of the cost (>80%) was as a result of work-related costs. Conclusion: The major cost of AS is as a result of loss of working hours, early retirement and unpaid carer’s time. Therefore, much of AS costs are hidden and not easy to quantify. Functional impairment is the main factor associated with increased cost of AS. Interventions which keep people in work to retirement age and reduce functional impairment would have the greatest impact on reducing costs of AS. The combination of patient-reported and linked routine data significantly enhanced the health economic analysis and this methodology that can be applied to other chronic conditions.

Suggested Citation

  • Roxanne Cooksey & Muhammad J Husain & Sinead Brophy & Helen Davies & Muhammad A Rahman & Mark D Atkinson & Ceri J Phillips & Stefan Siebert, 2015. "The Cost of Ankylosing Spondylitis in the UK Using Linked Routine and Patient-Reported Survey Data," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-17, July.
  • Handle: RePEc:plo:pone00:0126105
    DOI: 10.1371/journal.pone.0126105
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    References listed on IDEAS

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    1. Gisela Kobelt, 2006. "Costs and quality of life for patients with multiple sclerosis in Belgium," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(02), pages 24-33, July.
    2. Gisela Kobelt, 2006. "Costs and quality of life for patients with multiple sclerosis in Belgium," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(2), pages 24-33, July.
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    1. Aileen R. Neilson & Gareth T. Jones & Gary J. Macfarlane & Ejaz MI Pathan & Paul McNamee, 2022. "Generating EQ-5D-5L health utility scores from BASDAI and BASFI: a mapping study in patients with axial spondyloarthritis using longitudinal UK registry data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(8), pages 1357-1369, November.
    2. Jeong Seok Lee & Baek-Lok Oh & Hee Young Lee & Yeong Wook Song & Eun Young Lee, 2018. "Comorbidity, disability, and healthcare expenditure of ankylosing spondylitis in Korea: A population-based study," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-13, February.
    3. Axel Svedbom & Johan Dalén & Moa Ivergård & Rebekah H. Borse & Christopher M. Black & Karin Luttropp & Sumesh Kachroo, 2020. "The value of persistence in treatment with subcutaneous TNF-alpha inhibitors for ankylosing spondylitis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(1), pages 45-54, February.
    4. Paolo Angelo Cortesi & Carla Fornari & Paolo Gisondi & Florenzo Iannone & Ippazio Cosimo Antonazzo & Elisabetta Aloisi & Martina Fiocchi & Daniela Ritrovato & Lorenzo Giovanni Mantovani, 2023. "A Cross-Indication Budget Impact Model of Secukinumab for the Treatment of Psoriasis, Psoriatic Arthritis, Ankylosing Spondylitis and Non-radiographic Axial Spondyloarthritis in Italy," PharmacoEconomics - Open, Springer, vol. 7(3), pages 405-416, May.

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