Rheumatology Advance Access originally published online on July 27, 2004
Rheumatology 2004 43(11):1374-1382; doi:10.1093/rheumatology/keh324
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Rheumatology Vol. 43 No. 11 © British Society for Rheumatology 2004; all rights reserved
PAPER |
Rheumatoid arthritis is already expensive during the first year of the disease (the Swedish TIRA project)
1 Department of Clinical Medicine, Örebro University, 2 Division of Rheumatology, Department of Molecular and Clinical Medicine and 3 Centre for Medical Technology Assessment, Department of Health and Society, Linköping University, Sweden.
Correspondence to: T. Skogh, Rheumatology Unit, Department of Clinical Medicine, University Hospital of Örebro, SE-701 85 Örebro, Sweden. E-mail: thomas.skogh{at}lio.se
Objective. To calculate direct and indirect costs in early rheumatoid arthritis (RA) and to characterize patients generating high and low costs respectively.
Methods. Two hundred and ninety-seven patients with recent-onset (
12 months) RA were recruited. Clinical/laboratory data and ‘health assessment questionnaire’ (HAQ) were registered at inclusion and after 3, 6 and 12 months. After 6 and 12 months, the patients completed a questionnaire concerning health-care utilization and days lost from work. A cut-off point for direct costs was set at 34 000 Swedish kronor (
3675) defining one-third of the patients as a high-cost group and two-thirds as low-cost group. Indirect costs were calculated for patients aged <65 yr.
Results. Two hundred and eleven patients completed the HAQ on both occasions. Indirect costs exceeded direct costs by a factor of 2.3. Sixty three per cent experienced work disability during the first year and were identified as the ‘high-indirect-cost group’. Indirect costs accounted for >70% of total costs. Direct costs included ambulatory health care (76%), hospitalization (12%) and medication (9%). Men aged 
65 yr had low costs compared with younger men and women of all ages. In multiple logistic regression tests, HAQ, high levels of IgM rheumatoid factor (IgM RF) and poor hand function increased the odds of entering the high-direct-cost group, and poor hand function and pain increased the odds of entering the high-indirect-cost group.
Conclusions. Substantial costs were incurred during the first year after diagnosis of early RA, mainly due to work disability. Indirect costs were two to three times higher than direct costs. High levels of IgM RF, high HAQ score, poor hand function and pain increased the odds of entering high-cost groups.
KEY WORDS: Early rheumatoid arthritis, Outcome, Indirect costs, Direct costs, Cost of illness
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. BJORK, I. THYBERG, K. RIKNER, I. BALOGH, and B. GERDLE Sick Leave Before and After Diagnosis of Rheumatoid Arthritis --A Report from the Swedish TIRA Project J Rheumatol, June 1, 2009; 36(6): 1170 - 1179. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Abe, S. Wechs, S. Kalaydjiev, T. J. Franz, D. H. Busch, H. Fuchs, D. Soewarto, H. Behrendt, S. Wagner, T. Jakob, et al. Novel lymphocyte-independent mechanisms to initiate inflammatory arthritis via bone marrow-derived cells of Ali18 mutant mice Rheumatology, March 1, 2008; 47(3): 292 - 300. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Hallert, M. Husberg, and T. Skogh Costs and course of disease and function in early rheumatoid arthritis: a 3-year follow-up (the Swedish TIRA project) Rheumatology, March 1, 2006; 45(3): 325 - 331. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A Kavanaugh Health economics: implications for novel antirheumatic therapies Ann Rheum Dis, November 1, 2005; 64(suppl_4): iv65 - iv69. [Abstract] [Full Text] [PDF]
|
|