FRI0543 Is baseline disease activity associated with 1-year health care costs & productivity losses after biologic treatment start in patients with ra?. (23rd January 2014)

• Record Type: Journal Article
• Authors: Johansson, K.; Eriksson, J. K.; Miller, H.; van Vollenhoven, R. F.; Askling, J.; Neovius, M.
• Is Part Of: Annals of the rheumatic diseases. Volume 72:Supplement 3(2013)
• Page Start: A558
• Page End: A559
• Publication Date: 2014-01-23
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2013-eular.1670
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Little is known about the cost trajectory in patients starting biologics with moderate disease activity. Objectives: To compare 1-year health care costs and productivity losses after initiation of first biologic treatment in RA-patients with high vs moderate disease activity at treatment start. Methods: In the Swedish Biologics Register (ARTIS), we identified patients with RA starting their first biologic in 2007-2009 who had baseline DAS28 recorded (n=2143; 138 low [DAS28 <3.2], 898 moderate [DAS28 3.2-5.0], and 1107 high disease activity [DAS28 ≥5.1]). Data on inpatient and nonprimary outpatient care, prescription drugs, and productivity losses were retrieved from nationwide registers. Mean cost differences (expressed in 2010 €) with 95%CIs were estimated using nonparametric bootstrapping, adjusting for age, sex, and costs during the previous year. Results: Patients with high baseline disease activity were older than those with moderate disease activity (59 vs 56y; P<.001), but did not differ regarding sex (75% vs 75% women; P=.99) or disease duration (10 vs 9y; P=.14). 64% of patients with high and 75% with moderate disease activity were of working age (18-64y; P<.001). During the year after initiation of biologics, patients starting with high and moderate disease activity accumulated health care costs of €17, 993 and €16, 488, respectively (adj. difference €965, 95%CI 2-1951). In working age patients, high (vs moderate) baseline disease activity was associated with greater productivity losses (€23, 837 vs €18, 394; adj. difference €1550, 95%CI 538-2562). For patients starting biologics with high compared to moderate disease activity the total 1-year costs were €41, 089 vs €34, 416 (Figure ; adj. difference €2079, 95%CI 586-3572). Image/graph: Conclusions: Patients initiating biologic treatment with high compared to moderate baseline disease activity accumulated more costs over 1 year. After adjustment, the costs were higher for inpatient care and productivity losses, but not for nonprimary outpatient care or drugs. Acknowledgements: The study was partly funded by Pfizer. Disclosure of Interest: None Declared