AB0654 Consumption of health resources in rheumatoid arthritis health and fibromyalgia.

Abstract

Background The patient with fibromyalgia (FM) is, according to many publications, a major consumer of health resources with a significant increase in emergency assistance, hospitalization and complementary tests. The Spanish guidelines for FM since 2006 define very strictly which tests are necessary for these patients and follow up consultations in primary care. Rheumatoid arthritis (RA) is a complex disease that may require considerable hospital resources and whose follow up tend to be in the hospital (in our environment), which is why it has been selected for cost comparison. Objectives We propose to study the hospital costs represented by patients with FM over a one year period compared to the cost of RA. Methods We selected all the patients with the previous diagnosis of FM or RA who were attending the rheumatology consultation between the first until the 30 June 2012 We reviewed the one year expenses incurred from hospital visits, interconsultations and complementary tests. Surgery and the consumption of pharmaceutical drugs were excluded from the study. New patients were analyzed independently from those attending follow ups consultations. Results We recruited 48 FM and 53 RA, 1 man in the FM group and 8 in the RA group. The average age was 51 years for FM and 62 for RA. The patients affected by RA made up 56% more visits/year than FM to Rheumatology. The number of visits to other Units was similar in both groups: 229 versus 234. The number of imaging tests was 52 for FM and 115 in the RA. Laboratory tests (blood analysis, urinalysis, blood cultures) were 46 for FM versus 181 in RA and the number of hospitalization days was 5 times greater for RA group. On the other hand the cost of other tests such as MRI, CT-guided blocks, EEG, endoscopy or ultrasound is double in the case of FM. The average annual cost of FM was € 1100 per patient/ year and the RA €1600/year. Analytical tests and hospitalization make up 41% of the Hospital cost of FM and 24% of RA. For FM, 41% of the cost is attributed to other consults different than Rheumatology, whereas 24% for RA. No differences were detected between groups of new patients and those currently being treated (whether by biological treatment or not). Conclusions We note that in rheumatology spending is much lower in FM than in RA but not in the diagnostic tests that seem to correlate with the number of visits in other Departments that rheumatology which is similar in both groups, which could be due to the guidelines for FM it’s not know for other specialties. The RA group was older than FM and that may have caused a bias in the measurement of the cost. The annual cost is far from the published ranges of € 9500-10500 per year for FM and € 2055-5634 per year for RA, but in that studies drug expenditure and the cost of employee absence are included. The implementation of treatment guidelines of the FM in other areas than the Rheumatology might be important in reducing costs. Disclosure of Interest None Declared