Rheumatoid Arthritis: Cooper NJ

Cooper NJ. · School of Health Policy and Practice, Elizabeth Fry Building, University of East Anglia, Norwich NR4 7TJ, UK. · Rheumatology (Oxford). · Pubmed #10662870 links to  free full text

Abstract: OBJECTIVE: To summarize the state of knowledge with regard to the economic impact of rheumatoid arthritis (RA) and to highlight any weaknesses in the work conducted to date, so as to inform future RA cost-of-illness studies. METHODS: Four computerized literature databases were searched to identify all the literature relevant to this review. Seven elements indicating a quality cost-of-illness study were established and used to appraise the literature identified critically. Where possible, costs reported by the different studies were converted to 1996 US dollars using the consumer price index for medical care. RESULTS: Total average medical costs were reported to range from US$5720 (UK pound3575) to US$5822 (UK pound3638). Medication constituted between 8 and 24% of total medical costs, physician visits between 8 and 21%, and in-patient stays between 17 and 88%. The average number of days absent from work due to a person's RA was reported to range from 2.7 to 30 days/year. CONCLUSION: The economic impact of RA in terms of cost was reported to be substantial by all studies reviewed. However, methodological problems meant that discrepancies in the average (per person) annual cost of RA existed across studies.

Cooper NJ, Mugford M, Symmons DP, Barrett EM, Scott DG. · Department of Epidemiology and Public Health, University of Leicester, Leicester, UK. · Rheumatology (Oxford). · Pubmed #12096226 links to  free full text

Abstract: OBJECTIVE: To estimate the health service, non-health service and total costs and predictors of costs in individuals with early inflammatory polyarthritis (IP). METHODS: We conducted a prospective longitudinal study over a 6-month period. The participants were a random sample of 133 individuals who had enrolled with the community-based Norfolk Arthritis Register (NOAR) database between 1994 and 1999. The main outcome measures were the mean (per person) 6-month health service cost, non-health-service cost and total cost associated with IP. RESULTS: One hundred and fifteen of the 133 individuals who were recruited into the study completed 6 months of follow-up. The mean 6-month total cost was estimated to be 2800 pounds sterling per person, of which 14% was health service costs and the remainder non-health-service costs. Higher total costs were associated with lower health status and rheumatoid factor positivity. CONCLUSIONS: Early IP has a considerable impact on both the health-care system and, more importantly, society. Non-health-service costs (i.e. costs incurred by the individual with the disease, their family and friends) account for a substantial proportion (86%) of the total costs associated with early IP.

Cooper NJ, Mugford M, Scott DG, Barrett EM, Symmons DP. · School of Health Policy and Practice, University of East Anglia, Norwich, England. · J Rheumatol. · Pubmed #10990221 No free full text.

Abstract: OBJECTIVE: To estimate the secondary health service care and second line drug costs (including drug monitoring costs) for a cohort of people with early inflammatory polyarthritis (IP) and the subgroup classified as having rheumatoid arthritis (RA) recruited to a population based register. METHODS: The study population consisted of 344 people with IP who had enrolled on the Norfolk Arthritis Register (NOAR) in 1990-91, an average of 24 weeks after onset of their symptoms. Utilizing resource use data from NOAR, augmented by unit cost data from other sources, the average (per person) and cumulative secondary care and second line drug costs were estimated for Years 1, 2, 3, 4, and 5 following registration with NOAR. RESULTS: The total secondary health service care and second line drug costs were 472,125 (338,704 for RA subgroup) (1990-91 prices) over the 5 year study period, with inpatient stays, outpatient visits, and second line drugs accounting for 58, 9, and 33%, respectively. Nineteen percent of the study population neither visited hospital nor were prescribed second line drugs. CONCLUSION: Overall, inpatient stay costs represented the largest proportion of secondary health service care and second line drug costs, making 21% of the total study cohort responsible for 80% of the total 5 year costs incurred.