title: Secondary health service care and second line drug costs of early inflammatory polyarthritis in Norfolk, UK.
abstract: OBJECTIVE
  To estimate the secondary health service care and second line drug costs (including drug monitoring costs) for a cohort of people with early inflammatory polyarthritis (IP) and the subgroup classified as having rheumatoid arthritis (RA) recruited to a population based register.
  
  
  METHODS
  The study population consisted of 344 people with IP who had enrolled on the Norfolk Arthritis Register (NOAR) in 1990-91, an average of 24 weeks after onset of their symptoms. Utilizing resource use data from NOAR, augmented by unit cost data from other sources, the average (per person) and cumulative secondary care and second line drug costs were estimated for Years 1, 2, 3, 4, and 5 following registration with NOAR.
  
  
  RESULTS
  The total secondary health service care and second line drug costs were 472,125 (338,704 for RA subgroup) (1990-91 prices) over the 5 year study period, with inpatient stays, outpatient visits, and second line drugs accounting for 58, 9, and 33%, respectively. Nineteen percent of the study population neither visited hospital nor were prescribed second line drugs.
  
  
  CONCLUSIONS
  Overall, inpatient stay costs represented the largest proportion of secondary health service care and second line drug costs, making 21% of the total study cohort responsible for 80% of the total 5 year costs incurred.
authors.affiliation: School of Health Policy and Practice, University of East Anglia, Norwich, England. n.cooper@uea.ac.uk
authors.forename: N J
authors.initials: NJ
authors.lastname: Cooper
authors.forename: M
authors.initials: M
authors.lastname: Mugford
authors.forename: D G
authors.initials: DG
authors.lastname: Scott
authors.forename: E M
authors.initials: EM
authors.lastname: Barrett
authors.forename: D P
authors.initials: DP
authors.lastname: Symmons
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000191:economics; D001168:Arthritis / Q000191:economics* / Q000628:therapy; D015331:Cohort Studies; D003365:Costs and Cost Analysis / Q000706:statistics & numerical data; D004180:Direct Service Costs / Q000706:statistics & numerical data*; D016527:Drug Costs / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D018675:Toxicity Tests / Q000191:economics; D006113:United Kingdom