1. Direct Cost-Modeling of Rheumatoid Arthritis According to Disease Activity Categories in France
- Author
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Ariel Beresniak, Laure Gossec, Alain Saraux, Danielle Dupont, Marion Bamberger, Bruno Bregman, Philippe Goupille, Génétique, immunothérapie, chimie et cancer (GICC), UMR 6239 CNRS [2008-2011] (GICC UMR 6239 CNRS), Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS), and Cambefort, Jeanne
- Subjects
medicine.medical_specialty ,Cost estimate ,[SDV]Life Sciences [q-bio] ,Immunology ,MEDLINE ,Arthritis ,Severity of Illness Index ,Arthritis, Rheumatoid ,Disease activity ,DISEASE ACTIVITY SCORE ,03 medical and health sciences ,0302 clinical medicine ,MODELING ,Cost of Illness ,Rheumatology ,Internal medicine ,Severity of illness ,medicine ,Humans ,Immunology and Allergy ,030212 general & internal medicine ,RHEUMATOID ARTHRITIS ,health care economics and organizations ,030203 arthritis & rheumatology ,business.industry ,Remission Induction ,Health Care Costs ,Direct cost ,medicine.disease ,3. Good health ,[SDV] Life Sciences [q-bio] ,Models, Economic ,Rheumatoid arthritis ,Physical therapy ,France ,business ,Monte Carlo Method - Abstract
Objective.The objective of this cost-of-illness study was to assess the use of direct medical resources, excluding drug costs, by patients with rheumatoid arthritis (RA) in France, and to construct cost estimates according to level of disease activity.Methods.Three categories of RA disease activity were defined according to Disease Activity Score 28-joint count (DAS28) thresholds: remission (DAS28 < 2.6), low disease activity state (LDAS; i.e., DAS28 ≤ 3.2), and moderate to high disease activity (MHDAS; i.e., DAS28 > 3.2). Eight resource utilization items were defined: medical visits, laboratory tests, hospitalization, imaging, physiotherapy, nursing, adaptive aids, and transportation. Resource utilization and unit costs from the national-payer perspective were estimated through expert opinion and simulated using distribution ranges for each item. Cost distributions were computed by Monte-Carlo simulations estimating overall costs per 6 months over a 2-year period.Results.For patients achieving remission, costs were estimated at a mean of €771 (SD 199) for the first 6 months and at €511 (SD 162) for each subsequent 6-month period. For patients achieving LDAS, costs were estimated at €905 (SD 263) for the first 6 months and €696 (SD 240) for each subsequent 6-month period. For patients in MHDAS, costs were estimated at €1215 per 6 months (SD 405).Conclusion.This cost-of-illness assessment provided current estimates of direct medical costs for RA according to disease activity in France. The findings suggest that achieving remission or LDAS is associated with substantially lower medical costs for RA versus being in MHDAS.
- Published
- 2010