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Utility and direct costs:ankylosing spondylitis compared with rheumatoid arthritis
  1. S. M.M. Verstappen (s.verstappen{at}azu.nl)
  1. Dept. of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Netherlands
    1. J. W.G. Jacobs
    1. Dept. of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Netherlands
      1. D. M. van der Heijde
      1. Dept. of Rheumatology, University Hospital Maastricht, Netherlands
        1. Sj van der Linden
        1. Dept. of Rheumatology, University Hospital Maastricht, Netherlands
          1. C. M. Verhoef
          1. Dept. of Rheumatology, Flevo Hospital Almere, Netherlands
            1. J. W.J. Bijlsma
            1. Dept. of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Netherlands
              1. A. Boonen
              1. Dept. of Rheumatology, University Hospital Maastricht, Netherlands

                Abstract

                Objectives: To compare utility and disease specific direct costs between patients with ankylosing spondylitis (AS) and patients with rheumatoid arthritis (RA) in The Netherlands.

                Methods: Patients with AS and RA completed questions on disease characteristics, the EQ-5D to assess utility, and resource utilisation. Resource utilization was assessed prospectively in AS, but retrospectively in RA. True cost estimates (2003) were used to calculate the costs. Differences in disease characteristics between AS and RA were described and determinants of EQ-5D utility and costs were explored by Cox proportional hazard regressions.

                Results: 576 RA-patients and 132 AS-patients completed the questionnaires. EQ-5D utility (0.63 vs 0.7) was lower, and annual direct costs higher in RA (€5,167 vs €2,574). In multivariate Cox proportional hazard regressions, there was no difference in utility between the diagnostic groups, but patients with RA incurred higher direct costs after controlling for age, gender, and disease duration.

                Conclusions: In patients with RA and AS who are under care of a rheumatologist, utility is equally reduced but healthcare costs are higher in RA after controlling for age, gender, and disease duration. These data can be helpful to provide insights in differences and similarities between the healthcare needs of both patient groups and to identify issues for further research and for policy in health care organizations.

                • ankylosing spondylitis
                • direct costs
                • rheumatoid arthritis
                • utility

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