Cost of illness and determinants of costs among patients with gout.
OBJECTIVE
To estimate costs of illness in a cross-sectional cohort of patients with gout attending an outpatient rheumatology clinic, and to evaluate which factors contribute to higher costs.


METHODS
Altogether, 126 patients with gout were clinically assessed. They completed a series of questionnaires. Health resource use was collected using a self-report questionnaire that was cross-checked with the electronic patient file. Productivity loss was assessed by the Work Productivity and Activity Impairment Questionnaire, addressing absenteeism and presenteeism. Resource use and productivity loss were valued by real costs, and annual costs per patient were calculated. Factors contributing to incurring costs above the median were explored using logistic univariable and multivariable regression analysis.


RESULTS
Mean (median) annual direct costs of gout were €5647 (€1148) per patient. Total costs increased to €6914 (€1279) or €10,894 (€1840) per patient per year when adding cost for absenteeism or both absenteeism and presenteeism, respectively. Factors independently associated with high direct and high indirect costs were a positive history of cardiovascular disease, functional limitations, and female sex. In addition, pain, gout concerns, and unmet gout treatment needs were associated with high direct costs.


CONCLUSIONS
The direct and indirect costs-of-illness of gout are primarily associated with cardiovascular disease, functional limitations, and female sex.
From the Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Care and Public Health Research Institute (CAPHRI), University Maastricht, Maastricht, the Netherlands; and Département de Rhumatologie, Centre Hospitalier Universitaire du Sart-Tilman, Liège, Belgium.B. Spaetgens, MD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and CAPHRI Research Institute, University Maastricht; J.M.A. Wijnands, MSc; S. van der Linden, MD, PhD; A. Boonen MD, PhD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and CAPHRI Research Institute, University Maastricht; C. van Durme, MD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and Département de Rhumatologie, Centre Hospitalier Universitaire du Sart-Tilman. bartholomeus.spaetgens@mumc.nl.
Bart
B
Spaetgens
From the Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Care and Public Health Research Institute (CAPHRI), University Maastricht, Maastricht, the Netherlands; and Département de Rhumatologie, Centre Hospitalier Universitaire du Sart-Tilman, Liège, Belgium.B. Spaetgens, MD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and CAPHRI Research Institute, University Maastricht; J.M.A. Wijnands, MSc; S. van der Linden, MD, PhD; A. Boonen MD, PhD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and CAPHRI Research Institute, University Maastricht; C. van Durme, MD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and Département de Rhumatologie, Centre Hospitalier Universitaire du Sart-Tilman.
José M A
JM
Wijnands
From the Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Care and Public Health Research Institute (CAPHRI), University Maastricht, Maastricht, the Netherlands; and Département de Rhumatologie, Centre Hospitalier Universitaire du Sart-Tilman, Liège, Belgium.B. Spaetgens, MD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and CAPHRI Research Institute, University Maastricht; J.M.A. Wijnands, MSc; S. van der Linden, MD, PhD; A. Boonen MD, PhD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and CAPHRI Research Institute, University Maastricht; C. van Durme, MD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and Département de Rhumatologie, Centre Hospitalier Universitaire du Sart-Tilman.
Caroline
C
van Durme
From the Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Care and Public Health Research Institute (CAPHRI), University Maastricht, Maastricht, the Netherlands; and Département de Rhumatologie, Centre Hospitalier Universitaire du Sart-Tilman, Liège, Belgium.B. Spaetgens, MD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and CAPHRI Research Institute, University Maastricht; J.M.A. Wijnands, MSc; S. van der Linden, MD, PhD; A. Boonen MD, PhD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and CAPHRI Research Institute, University Maastricht; C. van Durme, MD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and Département de Rhumatologie, Centre Hospitalier Universitaire du Sart-Tilman.
Sjef
S
van der Linden
From the Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Care and Public Health Research Institute (CAPHRI), University Maastricht, Maastricht, the Netherlands; and Département de Rhumatologie, Centre Hospitalier Universitaire du Sart-Tilman, Liège, Belgium.B. Spaetgens, MD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and CAPHRI Research Institute, University Maastricht; J.M.A. Wijnands, MSc; S. van der Linden, MD, PhD; A. Boonen MD, PhD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and CAPHRI Research Institute, University Maastricht; C. van Durme, MD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and Département de Rhumatologie, Centre Hospitalier Universitaire du Sart-Tilman.
Annelies
A
Boonen
D000041:Absenteeism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004526:Efficiency; D005260:Female; D006073:Gout / Q000191:economics*; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires
ABSENTEEISM; COMORBIDITIES; COST OF ILLNESS; ECONOMIC EVALUATION; GOUT; PRESENTEEISM