Indirect and direct costs of treating patients with ankylosing spondylitis in the Brazilian public health system.
BACKGROUND
Patients with ankylosing spondylitis require a team approach from multiple professionals, various treatment modalities for continuous periods of time, and can lead to the loss of labour capacity in a young population. So, it is necessary to measure its socio-economic impact.


OBJECTIVE
To describe the use of public resources to treat AS in a tertiary hospital after the use of biological medications was approved for treating spondyloarthritis in the Health Public System, establishing approximate values for the direct and indirect costs of treating this illness in Brazil.


METHODS
93 patients selected from the ambulatory spondyloarthritis clinic at the Hospital de Clínicas of the Federal University of Paraná between September 2011 and September 2012 had their direct costs indirect treatment costs estimation.


RESULTS
70 patients (75.28%) were male and 23 (24.72%) female. The mean age was 43.95 years. The disease duration was calculated based on the age of diagnosis and the mean was 8.92 years (standard deviation: 7.32); 63.44% were using anti-tumour necrotic factor drugs. Comparing male and female patients the mean Bath Ankylosing Spondylitis Disease Activity Index was 4.64 and 5.49 while the mean Bath Ankylosing Spondylitis Functional Index was 5.03 and 6.35 respectively.


CONCLUSIONS
The Brazilian public health system's spending related to ankylosing spondylitis has increased in recent years. An important part of these costs is due to the introduction of new, more expensive health technologies, as in the case of nuclear magnetic resonance and, mainly, the incorporation of anti-tumour necrotic factor therapy into the therapeutic arsenal. The mean annual direct and indirect cost to the Brazilian public health system to treat a patient with ankylosing spondylitis, according to our findings, is US$ 23,183.56.
Hospital de Clínicas, Universidade Federal do Paraná, Paraná, PR, Brazil. Electronic address: valderilio@hotmail.com.
Valderilio Feijó
VF
Azevedo
Hospital de Clínicas, Universidade Federal do Paraná, Paraná, PR, Brazil.
Chayanne N
CN
Rossetto
Hospital de Clínicas, Universidade Federal do Paraná, Paraná, PR, Brazil.
Pedro G
PG
Lorencetti
Hospital de Clínicas, Universidade Federal do Paraná, Paraná, PR, Brazil.
Mariana Y
MY
Tramontin
Hospital de Clínicas, Universidade Federal do Paraná, Paraná, PR, Brazil.
Bruna
B
Fornazari
Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Denizar V
DV
Araújo
D000328:Adult; D001938:Brazil; D003365:Costs and Cost Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D011634:Public Health; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000191:economics*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha
Ankylosing spondylitis; Custos diretos; Custos indiretos; Direct costs; Espondilite anquilosante; Farmacoeconomia; Indirect costs; Pharmacoeconomy; Qualidade de vida; Quality of life