Economic consequences of the progression of rheumatoid arthritis in Sweden

Citation
G. Kobelt et al., Economic consequences of the progression of rheumatoid arthritis in Sweden, ARTH RHEUM, 42(2), 1999, pp. 347-356
Citations number
44
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Rheumatology,"da verificare
Journal title
ARTHRITIS AND RHEUMATISM
ISSN journal
0004-3591 → ACNP
Volume
42
Issue
2
Year of publication
1999
Pages
347 - 356
Database
ISI
SICI code
0004-3591(199902)42:2<347:ECOTPO>2.0.ZU;2-F
Abstract
Objective. To develop a simulation model for analysis of the cost-effective ness of treatments that affect the progression of rheumatoid arthritis (RA) . Methods, The Markov model was developed on the basis of a Swedish cohort of 116 patients with early RA who were followed up for 5 years. The majority of patients had American College of Rheumatology (ACR) functional class II disease, and Markov states indicating disease severity were defined based o n Health Assessment Questionnaire (HAQ) scores. Costs were calculated from data on resource utilization and patients' work capacity. Utilities (prefer ence weights for health states) were assessed using the EQ-5D (EuroQol) que stionnaire. Hypothetical treatment interventions were simulated to illustra te the model. Results. The cohort distribution among the 6 Markov states clearly showed t he progression of the disease over 5 years of followup. Costs increased wit h increasing severity of the Markov states, and total costs over 5 years we re higher for patients who were in more severe Markov states at diagnosis. Utilities correlated well with the Markov states, and the EQ-5D was able to discriminate between patients with different HAQ scores within ACR functio nal class II. Conclusion. The Markov model was able to assess disease progression and cos ts in RA. The model can therefore be a useful tool in calculating the cost- effectiveness of different interventions aimed at changing the progression of the disease.