PMS24 The Cost of Care of Rheumatoid Arthritis and Ankylosing Spondylitis Patients in Tertiary Care Rheumatology Units in Turkey

Malhan, S; Pay, Salih; Ataman, Şebnem; Dalkılıç, Ediz; Di̇nç, Ayhan; Erken, Eren; Ertenli, İhsan; Ertuğrul, Esin; Göğüş, Feride; Hamuryudan, Vedat; İnanç, Murat; Karaaslan, Yaşar; Karadağ, Ömer; Karakoç, Yüksel; Keskin, Göksal; Kısacık, Bünyamin; Kiraz, Sedat; Öksel, Fahrettin; Öksüz, E; Parildar, T.; Sarı, İ̇smail; Soy, Mehmet; Şentürk, Taşkın; Taylan, Ali

doi:10.1016/j.jval.2011.08.410

Cited by 7 publications

(10 citation statements)

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“…No previously published studies include such data. A recent study by Malhan et al [ 20 ] examined direct and indirect costs of AS patients in Turkey, which was limited because the data were gathered from an expert panel. Although an expert panel is a relatively inexpensive and rapid tool to produce a synthetic judgment based on qualitative and quantitative data, it has some limitations.…”

Section: Discussionmentioning

confidence: 99%

Direct and indirect costs associated with ankylosing spondylitis and related disease activity scores in Turkey

et al. 2015

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This study assessed quality of life, direct and indirect healthcare costs related to ankylosing spondylitis (AS). This study included 650 prevalent AS patients visiting seven centers at tertiary healthcare institutions in Turkey who were interviewed using a standard questionnaire to determine annual direct and indirect healthcare costs. Eligible patients were age ≥18 years with AS for at least 12 months. Direct costs were categorized as inpatient, outpatient and pharmacy, and AS-related consultation. Indirect costs were categorized as workday loss, additional AS-related costs, and caregiver costs. Clinical outcome measures were obtained, including Patients’ Global Disease Activity (Pt-GDA); visual analog scale (Pain-VAS) for pain; Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Functional Index (BASFI), and Metrology Index (BASMI) scores, and EuroQoL 5 dimension (EQ-5D) health status survey scores. Mean (€4,335.20) and median (€5,671.00) annual costs per patient were calculated. Pharmacy costs (€4,032.73) were highest among overall expenditures, followed by additional AS-related consultation (€2,480.38), outpatient (€225.02), and inpatient costs (€29.98). Over half of AS patients (54.8 %) experienced work loss. Related average annual costs were €414.16, based on income level. 10.3 % of AS patients incurred an additional €2,008.07 in 1 year. 6.8 % of patients required caregivers and incurred €778.70 in average annual patient paid costs. Mean Pt-GDA, Pain-VAS, EQ-5D, BASDAI, BASFI, and BASMI scores were 4.4, 40.5, 62.7, 3.6, 3.1, and 2.9, respectively. Direct and indirect AS-related costs are high and represent a considerable economic burden on Turkish AS patients.

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Section: Discussionmentioning

confidence: 99%

Direct and indirect costs associated with ankylosing spondylitis and related disease activity scores in Turkey

et al. 2015

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“…The only prior studies to analyze AS costs in Turkey were based on expert opinion, in which estimated direct costs were approximately € 3.566 [23]. Other studies examined the epidemiology of AS [8, 24–26].…”

Section: Discussionmentioning

confidence: 99%

Health Care Costs Associated with Ankylosing Spondylitis in Turkey: An Analysis from Nationwide Real-World Data

Başer

Bürkan

Baser

et al. 2013

International Journal of Rheumatology

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Objectives. To explore health care costs associated with ankylosing spondylitis (AS) in Turkey. Methods. Research-identified data from a system that processes claims for all Turkish health insurance funds were analyzed. Adult prevalent and incident AS patients with two AS visits at least 60 days apart, identified between June 1, 2010 and December 31, 2010, with at least 1 year of continuous health plan enrollment for the baseline and follow-up years were included in the study. Pharmacy, outpatient, and inpatient claims were compiled over the study period for the selected patients. Generalized linear models were used to estimate the expected annual costs, controlling for baseline demographic and clinical characteristics. Results. A total of 2.986 patients were identified, of which 603 were incident cases and 2.383 prevalent cases. The mean ages were 39 and 41 years, respectively, and 44% and 38% were women for incident and prevalent cases. Prevalent patients had higher comorbidity scores (5.01 versus 2.24, P < 0.001) and were more likely to be prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) (77% versus 72%, P < 0.001) or biologics (35% versus 8%, P < 0.006) relative to incident patients. Seventy-seven percent of prevalent patients were prescribed NSAIDs, followed by biologic and disease-modifying antirheumatic drugs (DMARDs). Total annual medical costs for incident AS patients were €2.253 and €4.233 for prevalent patients. Pharmacy costs accounted for a significant portion of total costs (88% for prevalent patient, 77% for incident patient), followed by physician office visit costs. Prior comorbidities and treatment type also significantly contributed to overall costs. Conclusion. Annual expenditures for AS patients in Turkey were comparable relative to European countries. Pharmaceutical expenditures cover a significant portion of the overall costs. Comparative effectiveness studies are necessary to further decrease health care costs of AS treatment.

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“…A lack of medication adherence leads to an increase in unnecessary visits, hospitalizations (2), and medication costs (3,4). Health policy makers aim to decrease these because of critical economic issues (1,(5)(6)(7)(8). Medication adherence is mainly affected by the patients themselves, the healthcare system, the disease pattern, and treatment-related factors.…”

Section: Introductionmentioning

confidence: 99%

Oral ulcer activity in Behcet’s disease: Poor medication adherence is an underestimated risk factor

et al. 2017

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Objective: The aim of this study was to evaluate the relationship between oral ulcer activity and medication adherence according to gender in Behçet's disease (BD) patients. Material and Methods:The study group included 330 BD patients (F/M: 167/163, mean age: 38.5±10.5 years). Oral ulcer activity and medication adherence were evaluated in the previous month. Medication adherence was evaluated using the 8-item Morisky Medication Adherence Scale (MMAS-8) having a score range of "0" to "8" with high scores indicating better adherence. Low adherence was defined as <6 points on MMAS-8.Results: Over half of the group had active oral ulcers (n=219, 66.4%) within the month preceding the visit. The number of oral ulcers was significantly higher in female patients with low medication adherence (2.39±3.24) than in the rest of the female group (1.28±2.05; p=0.023). Although a similar trend was also observed in male patients (2.14±3.3 vs. 1.81±2.31), a significant relationship was not observed (p=0.89). The frequency of medication intake per day was lower in patients with high medication adherence than in the rest of the study group (p=0.04). Conclusion:Low medication adherence is a hidden risk factor in the management of BD. Poor adherence was associated with oral ulcer activity in female BD patients.

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PMS24 The Cost of Care of Rheumatoid Arthritis and Ankylosing Spondylitis Patients in Tertiary Care Rheumatology Units in Turkey

Cited by 7 publications

References 0 publications

Direct and indirect costs associated with ankylosing spondylitis and related disease activity scores in Turkey

Direct and indirect costs associated with ankylosing spondylitis and related disease activity scores in Turkey

Health Care Costs Associated with Ankylosing Spondylitis in Turkey: An Analysis from Nationwide Real-World Data

Oral ulcer activity in Behcet’s disease: Poor medication adherence is an underestimated risk factor

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