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López-Bastida J, Linertová R, Oliva-Moreno J, Serrano-Aguilar P, Posada-de-la-Paz M, Kanavos P, Taruscio D, Schieppati A, Iskrov G, Péntek M, Delgado C, von der Schulenburg JM, Persson U, Chevreul K, Fattore G. Social/economic costs and health-related quality of life in patients with scleroderma in Europe. Eur J Health Econ 2016; 17 Suppl 1:109-117. [PMID: 27038626 DOI: 10.1007/s10198-016-0789-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 01/13/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this study was to determine the economic burden from a societal perspective and the health-related quality of life (HRQOL) of patients with systemic sclerosis (SSc; scleroderma) in Europe. METHODS We conducted a cross-sectional study of patients with SSc (involving both localised and systemic sclerosis) from Germany, Italy, Spain, France, the UK, Hungary and Sweden. Data on demographic characteristics, healthcare resource utilisation, informal care, labour productivity losses and HRQOL were collected from the questionnaires completed by patients or their caregivers. HRQOL was measured with the EuroQol 5-domain (EQ-5D) questionnaire. RESULTS A total of 589 patients completed the questionnaire. The rate of patients with localised scleroderma, limited cutan and diffuse cutan SSc were 28, 68 and 4 %, respectively. Average annual costs varied from country to country and ranged from € 4607 to € 30,797 (reference year: 2012). Estimated direct healthcare costs ranged from € 1413 to € 17,300; direct non-healthcare costs ranged from € 1875 to € 4684 and labour productivity losses ranged from € 1701 to € 14,444. The mean EQ-5D index score for adult SSc patients varied from 0.49 to 0.75 and the mean EQ-5D visual analogue scale score was between 58.72 and 65.86. CONCLUSION The main strengths of this study lie in our bottom-up approach to costing and our evaluation of SSs patients from a broad societal perspective. This type of analysis is very unusual in the international literature on rare diseases in comparison with other illnesses. We concluded that SSc patients incur considerable societal costs and experience substantial deterioration in HRQOL.
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Affiliation(s)
- Julio López-Bastida
- Universidad de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain.
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain.
| | - Renata Linertová
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Las Palmas de Gran Canaria, Spain
| | - Juan Oliva-Moreno
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Universidad de Castilla-La Mancha, Toledo, Spain
| | - Pedro Serrano-Aguilar
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Evaluation and Planning Service at Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | - Manuel Posada-de-la-Paz
- Instituto de Investigación en Enfermedades Raras (IIER), SpainRDR and CIBERER, Madrid, Spain
| | - Panos Kanavos
- Health and Social Care Research Centre, London School of Economics and Political Science, London, UK
| | - Domenica Taruscio
- National Center for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Arrigo Schieppati
- Centro di Ricerche Cliniche per Malattie Rare Aldo e Cele Daccò, Istituto di Ricerche Farmacologiche Mario Negri, Ranica (Bergamo), Italy
| | - Georgi Iskrov
- Institute of Rare Diseases, Plovdiv, Bulgaria
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Claudia Delgado
- Federación Española de Enfermedades Raras (FEDER), Madrid, Spain
| | | | - Ulf Persson
- Swedish Institute for Health Economics, Lund, Sweden
| | - Karine Chevreul
- URC Eco Ile de France, AP-HP, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, Paris, France
- INSERM, ECEVE, U1123, Paris, France
| | - Giovanni Fattore
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy
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Abstract
BACKGROUND Disease Management Programmes (DMP) are intended to improve the quality of the medical care of chronically sick patients and at the same time to keep stable or to reduce the costs to the healthcare system. The effectiveness of a DMP was evaluated by means of an accompanying study. METHOD Within the framework of the DMP, the patients were managed by case managers who carried out patient instructions, evaluated the symptoms and lung function values (FEV (1)) on a daily basis and supervised treatment goals with the aid of predetermined algorithms. Initially, in collaboration with the family doctor, a treatment schedule was drawn up continuously monitored and adapted. In a 12-month multicentre evaluation study, the quality of life of the patients was determined using the FLA and Euroquol questionnaires. Furthermore, symptoms, lung function (FEV (1)) and the total costs of the treatment were measured. RESULTS The quality of life (FLA, EuroQuol) of the patients in the Disease Management group was statistically significantly improved compared with the start of the study and with the control group. Inpatient respiratory-related costs were only incurred in the control group ( 320). No significant differences were found in the case of the other direct cost parameters (costs for asthma-related drugs 716 and 720 in the control group and DMP group respectively). The indirect costs were higher in the DMP group due to more frequent disability. With regard to overall symptoms, a pronounced reduction was only achieved in the DMP group. The mean FEV (1) measured in the physicians practice rose in the DMP group from 1.82 l to 1.89 l, whereas in the control group it fell slightly from 1.84 l to 1.78 l. The daily FEV (1) measurements at patient's home showed an increase of about 10 % in the values after 12 months. CONCLUSIONS The tested DMP for asthmatics brought about a significant improvement in the state of health, asthmatic symptoms and lung function of asthmatics. The direct costs of treatment were also found to be lower.
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Affiliation(s)
- W Petro
- Klinik Bad Reichenhall, Salzburger Str. 8-11, 83435 Bad Reichenhall
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