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The economic burden associated with osteoarthritis, rheumatoid arthritis, and hypertension: a comparative study
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  1. A Maetzel1,2,
  2. L C Li1,3,
  3. J Pencharz1,
  4. G Tomlinson4,5,
  5. C Bombardier1,4,6,
  6. the Community Hypertension and Arthritis Project Study Team
  1. 1Division of Clinical Decision Making and Health Care Research, University Health Network Research Institute, Toronto, Ontario, Canada
  2. 2Department of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
  3. 3The Arthritis Society, Ontario Division, Toronto, Ontario, Canada
  4. 4Department of Medicine, University of Toronto, Ontario, Canada
  5. 5Department of Public Health Sciences, University of Toronto, Ontario, Canada
  6. 6Mt Sinai Hospital, Toronto, Ontario, Canada
  1. Correspondence to:
    Dr A Maetzel
    University Health Network, 200 Elizabeth Street EN 6-232 A, Toronto, Ontario M5G 2C4, Canada; maetzeluhnres.utoronto.ca

Abstract

Objective: To compare the economic burden to society incurred by patients with RA, OA, or high blood pressure (HBP) in Ontario, Canada.

Methods: Consecutive subjects recruited by 52 rheumatologists (RA) and 76 family physicians (OA and HBP) were interviewed at baseline and 3 months. Information was collected on demographics, health status, and any comorbidities. A detailed, open ended resource utilisation questionnaire inquired about the use of medical and non-medical resources and patient and care giver losses of time and related expenses. Annual costs were derived as recommended by national costing guidelines and converted to American dollars (year 2000). Statistical comparisons were made using ordinary least squares regression on raw and log transformed costs, and generalised linear modelling with adjustment for age, sex, educational attainment, and presence of comorbidities.

Results: Baseline and 3 month interviews were completed by 253/292 (86.6%) patients with RA and 473/585 (80.9%) patients with OA and/or HBP. Baseline and total annual disease costs for RA (n = 253), OA and HBP (n = 191), OA (n = 140), and HBP (n = 142), respectively, were $9300, $4900, $5700, and US$3900. Indirect costs related to RA were up to five times higher than indirect costs incurred by patients with OA or HBP, or both. The presence of comorbidities was associated with disease costs for all diagnoses, cancelling out potential effects of age or sex.

Conclusion: The economic burden incurred by RA significantly exceeds that related to OA and HBP, while differences between patients with a diagnosis of OA without HBP or a diagnosis of HBP alone were non-significant, largely owing to the influence of comorbidities.

  • costs
  • hypertension
  • osteoarthritis
  • rheumatoid arthritis
  • COI, cost of illness
  • GDP, gross domestic product
  • GLM, generalised linear modelling
  • HBP, high blood pressure
  • OA, osteoarthritis
  • OLS, ordinary least squares
  • RA, rheumatoid arthritis
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