Cost-of-illness of rheumatoid arthritis and ankylosing spondylitis

OBJECTIVES:\ud To assess, quantify and summarise the cost of illness of rheumatoid arthritis (RA) and ankylosing spondylitis (AS) from the societal perspective.\ud \ud METHODS:\ud Original studies reporting costs of RA or AS were searched systematically. Both cost-of-illness studies and economic evaluations of therapies were included. Studies were appraised for patient and study characteristics, type of costs and actual costs. Reported costs were aggregated by cost categories and overall mean costs were summarised by cost domain (healthcare, patient and family, and productivity costs).\ud \ud RESULTS:\ud Overall mean costs of RA (€14,906 per year) were above that of AS (€9,374 per year), while the relative distribution of costs over cost domains was approximately similar. For both diseases, productivity costs based on the human cost approach were 3 to 10 times higher than the friction costs and accounted for more than half the total costs of both diseases.\ud \ud CONCLUSIONS:\ud Productivity costs constitute the largest part of the total cost-off-illness of RA and AS reflecting the high burden of the disease on work participation. Although total and direct costs of illness in RA were higher than in AS, the average age of AS patients was 10 years lower and therefore, lifetime costs associated with AS may actually be equal or higher

Cost effectiveness of medical versus surgical treatment in patients with severe or refractory gastroesophageal reflux disease in The Netherlands

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Exploring non-health outcomes of health promotion: The perspective of participants in a lifestyle behaviour change intervention

Objective: To provide insights into health promotion outcomes that are not captured by conventional measures of health outcome used in economic evaluation studies, such as EQ5D based QALYs. Methods: Twelve semi-structured interviews and five focus group discussions were conducted with participants of a randomized controlled trial (n= 52) evaluating the effectiveness of a theory-based lifestyle intervention in Dutch adults at risk for diabetes mellitus and/or cardiovascular disease. Transcripts were analysed by two independent researchers using a thematic analysis approach. Results: In total we identified twelve non-health outcome themes that were important from the participant perspective. Four of these were reported as direct outcomes of the lifestyle intervention and eight were reported as consequences of lifestyle behaviour change. Our findings also suggest that lifestyle behaviour change may have spillover effects to other people in the participants' direct environment. Conclusion: This study provides evidence that in the context of lifestyle behaviour change EQ5D based QALYs capture health promotion outcomes only partially. More insights are needed into non-health outcomes and spillover effects produced by health promotion in other contexts and how participants and society value these. Methods to account for these outcomes within an economic evaluation framework need to be developed and tested. © 2012 Elsevier Ireland Ltd

Cost-of-illness of rheumatoid arthritis and ankylosing spondylitis

Objective. To assess, quantify and summarise the cost of illness of rheumatoid arthritis (RA) and ankylosing spondylitis (AS) from the societal perspective Methods. Original studies reporting costs of RA or AS were searched systematically. Both cost-of-illness studies and economic evaluations of therapies were included. Studies were appraised for patient and study characteristics, type of costs and actual costs. Reported costs were aggregated by cost categories and overall mean costs were summarised by cost domain (healthcare, patient and family, and productivity costs). Results. Overall mean costs of RA ((sic)14.906 per year) were above that of AS ((sic)9,374 per Year), while the relative distribution (of costs over cost domains was approximately similar. For both diseases, productivity costs based on the human cost approach were 3 to 70 times higher than the friction costs and accounted for more than half the total costs of both diseases. Conclusion. Productivity costs constitute the largest part of the total cost-off-illness of RA and AS refleciing the high burden of the disease on work participation. Although total and direct costs of illness in RA were higher than tit AS, the average age of AS patients was 10 years lower and therefore, time costs associated with AS may actually be equal or higher

Cost-effectiveness of open versus laparoscopic repair for primary inguinal hernia.

University Hospital Maastricht. A cost-effectiveness (CE) analysis was performed of Bassini versus laparoscopic repair for primary inguinal hernia. Incremental costs per 1-year recurrence-free patient were calculated for the societal and hospital perspective. From the hospital perspective, the incremental CE ratio of laparoscopic repair is 5.348 guilders. From the societal perspective, laparoscopic repair is both less costly and more effective than Bassini repair. Results were sensitive to assumptions about recurrence rates, laparoscopic operating time, and return to work. Laparoscopic repair should replace Bassini repair in order to benefit society. From the hospital perspective, the decision to accept laparoscopic repair depends on the willingness to pay. Publication Types: Clinical Trial Randomized Controlled Tria