Cost of illness from the public payers' perspective in patients with ankylosing spondylitis in rheumatological care.
OBJECTIVE
To estimate the incremental costs to public payers for patients with ankylosing spondylitis (AS) of working age compared with reference subjects from the general population.


METHODS
We investigated total costs for 3 years (2005-2007) in 116 outpatients under 66 years of age with AS attending rheumatological care in Malmö, Sweden. Mean (SD) age was 46 (11) years and mean (SD) disease duration was 24 (11) years. Two subjects per AS patient matched for age, sex, and residential area were selected from the Population Register to serve as a reference group. We retrieved data concerning sick leave, prescription drugs, and healthcare consumption from Swedish health-cost registers by the unique personal identification numbers.


RESULTS
The mean total cost for the 3-year period 2005-2007 was US $37,095 (SD $30,091) for patients with AS, and $11,071 (SD $22,340) for the reference group. The mean indirect cost was $19,618 and $5905, respectively. Mean cost for healthcare was $8998 for the AS patients and $4187 for the reference subjects, and mean cost for drugs was $8479 and $979, respectively. The patients with AS treated with biological therapy constituted 80% of the total drug cost, but just 40% of the cost for disability pension.


CONCLUSIONS
Patients with AS had 3-fold increase in costs compared to reference subjects from the general population, and the drug costs were almost 10 times as high. Production losses (indirect cost) represented more than half of total cost (53%).
Strömbeck
Britta
B
Musculoskeletal Sciences Unit, Department of Orthopedics, Clinical Sciences Lund, Klinikgatan 22, Lund University Hospital, SE-221 85 Lund, Sweden. britta.strombeck@morse.nu
Englund
Martin
M
Bremander
Ann
A
Jacobsson
Lennart T H
LT
Kedza
Ljuba
L
Kobelt
Gisela
G
Petersson
Ingemar F
IF
D000328:Adult; D000368:Aged; D017281:Cost of Illness; D003362:Cost-Benefit Analysis / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D018582:Sick Leave / Q000191:economics*; D013167:Spondylitis, Ankylosing / Q000191:economics* / Q000628:therapy; D013548:Sweden