Direct costs of ankylosing spondylitis and its determinants:: an analysis among three European countries

被引:90
作者
Boonen, A
van der Heijde, D
Landewé, R
Guillemin, F
Rutten-van Mölken, M
Dougados, M
Mielants, H
de Vlam, K
van der Tempel, H
Boesen, S
Spoorenberg, A
Schouten, H
van der Linden, S
机构
[1] Univ Hosp, Dept Internal Med, Div Rheumatol, NL-6202 AZ Maastricht, Netherlands
[2] Univ Hosp, Dept Clin Epidemiol & Eval, Nancy, France
[3] Erasmus Univ, Inst Med Technol Assessment, Rotterdam, Netherlands
[4] Univ Paris 05, Dept Rheumatol, Hop Cochin, Paris, France
[5] Ghent Univ Hosp, Dept Rheumatol, B-9000 Ghent, Belgium
[6] Maasland Ziekenhuis Sittard, Sittard, Netherlands
[7] Univ Maastricht, Fac Hlth Sci, Maastricht, Netherlands
[8] Univ Maastricht, Dept Methodol & Stat, Maastricht, Netherlands
关键词
D O I
10.1136/ard.62.8.732
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To assess direct costs associated with ankylosing spondylitis (AS). To determine which variables, including country, predict costs. Methods: 216 patients with AS from the Netherlands, France, and Belgium participated in a two year observational study and filled in bimonthly economic questionnaires. Disease related healthcare resource use was measured and direct costs were calculated from a societal perspective (true cost estimates) and from a financial perspective (country-specific tariffs). Predictors of costs were assessed using Cox's regression analysis. Results: 209 patients provided sufficient data for cost analysis. Mean annual societal direct costs for each patient were E2640, of which 82% were direct healthcare costs. In univariate analysis costs were higher in the Netherlands than in Belgium, but this difference disappeared after adjusting for baseline differences in patients' characteristics among countries. Longer disease duration, lower education, worse physical function, and higher disease activity were predictors of costs. Mean annual direct costs from a financial perspective were E2122, E1402, and E941 per patient in the Netherlands, France, and Belgium, respectively. For each country, costs from a financial perspective were significantly lower than costs from a societal perspective. Conclusion: Direct costs for AS are substantial in three European countries but not significantly different after adjusting for baseline characteristics among countries. Worse physical function and higher disease activity are important determinants of costs, suggesting better disease control might reduce the costs of AS. The difference in costs from a societal and financial perspective emphasises the importance of an economic analysis.
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页码:732 / 740
页数:9
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