Real-World Health Care Outcomes and Costs Among Patients With Juvenile Idiopathic Arthritis in Spain
**Background:** Juvenile idiopathic arthritis (JIA) is the most frequent chronic rheumatic disease in children. If inflammation is not adequately treated, joint damage, long-term disability, and active disease during adulthood can occur. Identifying and implementing early and adequate therapy are cr...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Columbia Data Analytics, LLC
2023-12-01
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| Series: | Journal of Health Economics and Outcomes Research |
| Online Access: | https://doi.org/10.36469/001c.85088 |
| _version_ | 1797378097038753792 |
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| author | Jordi Antón Estefania Moreno Ruzafa Mireia Lopez Corbeto Rosa Bou Judith Sánchez Manubens Sonia Carriquí Arenas Joan Calzada Hernández Violetta Bittermann Carolina Estepa Guillén Juan Mosquera Angarita Lucía Rodríguez Díez Estíbaliz Iglesias Miguel Marti Masanet Berta Lopez Montesinos Maria I. González Fernández Alfonso de Lossada Carmen Peral Mónica Valderrama Noelia Llevat María Montoro Álvarez Immaculada Calvo Penadés |
| author_facet | Jordi Antón Estefania Moreno Ruzafa Mireia Lopez Corbeto Rosa Bou Judith Sánchez Manubens Sonia Carriquí Arenas Joan Calzada Hernández Violetta Bittermann Carolina Estepa Guillén Juan Mosquera Angarita Lucía Rodríguez Díez Estíbaliz Iglesias Miguel Marti Masanet Berta Lopez Montesinos Maria I. González Fernández Alfonso de Lossada Carmen Peral Mónica Valderrama Noelia Llevat María Montoro Álvarez Immaculada Calvo Penadés |
| author_sort | Jordi Antón |
| collection | DOAJ |
| description | **Background:** Juvenile idiopathic arthritis (JIA) is the most frequent chronic rheumatic disease in children. If inflammation is not adequately treated, joint damage, long-term disability, and active disease during adulthood can occur. Identifying and implementing early and adequate therapy are critical for improving clinical outcomes. The burden of JIA on affected children, their families, and the healthcare system in Spain has not been adequately assessed. The greatest contribution to direct costs is medication, but other expenses contribute to the consumption of resources, negatively impacting healthcare cost and the economic conditions of affected families.
**Objective:** To assess the direct healthcare, indirect resource utilization, and associated cost of moderate-to-severe JIA in children in routine clinical practice in Spain.
**Methods:** Children were enrolled in this 24-month observational, multicentric, cross-sectional, retrospective study (N = 107) if they had been treated with biologic disease-modifying anti-rheumatic drugs (bDMARDs), had participated in a previous study (ITACA), and continued to be followed up at pediatric rheumatology units at 3 tertiary Spanish hospitals. Direct costs included medication, specialist and primary care visits, hospitalizations, emergency visits or consultations, surgeries, physiotherapy, and tests. Indirect costs included hospital travel expenses and loss of caregiver working hours. Unitary costs were obtained from official sources (€, 2020).
**Results:** Overall, children had inactive disease/low disease activity according to JADAS-71 score and very low functional disability as measured by Childhood Health Assessment Questionnaire score. Up to 94.4% of children received treatment, mainly with bDMARDs as monotherapy (84.5%). Among anti-TNFα treatments, adalimumab (47.4%) and etanercept (40.2%) were used in similar proportions. Annual mean (SD) total JIA cost was €7516.40 (€5627.30). Average cost of pharmacological treatment was €3021.80 (€3956.20), mainly due to biologic therapy €2789.00 (€3399.80). Direct annual cost (excluding treatments) was €3654.60 (€3899.00). Indirect JIA cost per family was €747.20 (€1452.80).
**Conclusion:** JIA causes significant costs to the Spanish healthcare system and affected families. Public costs are partly due to the high cost of biologic treatments, which nevertheless remain an effective long-term treatment, maintaining inactive disease/low disease activity state; a very low functional disability score; and a good quality of life. |
| first_indexed | 2024-03-08T20:01:52Z |
| format | Article |
| id | doaj.art-334ca80fc5df49358d49deaab5f4e13c |
| institution | Directory Open Access Journal |
| issn | 2327-2236 |
| language | English |
| last_indexed | 2024-03-08T20:01:52Z |
| publishDate | 2023-12-01 |
| publisher | Columbia Data Analytics, LLC |
| record_format | Article |
| series | Journal of Health Economics and Outcomes Research |
| spelling | doaj.art-334ca80fc5df49358d49deaab5f4e13c2023-12-23T15:28:10ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362023-12-01102Real-World Health Care Outcomes and Costs Among Patients With Juvenile Idiopathic Arthritis in SpainJordi AntónEstefania Moreno RuzafaMireia Lopez CorbetoRosa BouJudith Sánchez ManubensSonia Carriquí ArenasJoan Calzada HernándezVioletta BittermannCarolina Estepa GuillénJuan Mosquera AngaritaLucía Rodríguez DíezEstíbaliz IglesiasMiguel Marti MasanetBerta Lopez MontesinosMaria I. González FernándezAlfonso de LossadaCarmen PeralMónica ValderramaNoelia LlevatMaría Montoro ÁlvarezImmaculada Calvo Penadés**Background:** Juvenile idiopathic arthritis (JIA) is the most frequent chronic rheumatic disease in children. If inflammation is not adequately treated, joint damage, long-term disability, and active disease during adulthood can occur. Identifying and implementing early and adequate therapy are critical for improving clinical outcomes. The burden of JIA on affected children, their families, and the healthcare system in Spain has not been adequately assessed. The greatest contribution to direct costs is medication, but other expenses contribute to the consumption of resources, negatively impacting healthcare cost and the economic conditions of affected families. **Objective:** To assess the direct healthcare, indirect resource utilization, and associated cost of moderate-to-severe JIA in children in routine clinical practice in Spain. **Methods:** Children were enrolled in this 24-month observational, multicentric, cross-sectional, retrospective study (N = 107) if they had been treated with biologic disease-modifying anti-rheumatic drugs (bDMARDs), had participated in a previous study (ITACA), and continued to be followed up at pediatric rheumatology units at 3 tertiary Spanish hospitals. Direct costs included medication, specialist and primary care visits, hospitalizations, emergency visits or consultations, surgeries, physiotherapy, and tests. Indirect costs included hospital travel expenses and loss of caregiver working hours. Unitary costs were obtained from official sources (€, 2020). **Results:** Overall, children had inactive disease/low disease activity according to JADAS-71 score and very low functional disability as measured by Childhood Health Assessment Questionnaire score. Up to 94.4% of children received treatment, mainly with bDMARDs as monotherapy (84.5%). Among anti-TNFα treatments, adalimumab (47.4%) and etanercept (40.2%) were used in similar proportions. Annual mean (SD) total JIA cost was €7516.40 (€5627.30). Average cost of pharmacological treatment was €3021.80 (€3956.20), mainly due to biologic therapy €2789.00 (€3399.80). Direct annual cost (excluding treatments) was €3654.60 (€3899.00). Indirect JIA cost per family was €747.20 (€1452.80). **Conclusion:** JIA causes significant costs to the Spanish healthcare system and affected families. Public costs are partly due to the high cost of biologic treatments, which nevertheless remain an effective long-term treatment, maintaining inactive disease/low disease activity state; a very low functional disability score; and a good quality of life.https://doi.org/10.36469/001c.85088 |
| spellingShingle | Jordi Antón Estefania Moreno Ruzafa Mireia Lopez Corbeto Rosa Bou Judith Sánchez Manubens Sonia Carriquí Arenas Joan Calzada Hernández Violetta Bittermann Carolina Estepa Guillén Juan Mosquera Angarita Lucía Rodríguez Díez Estíbaliz Iglesias Miguel Marti Masanet Berta Lopez Montesinos Maria I. González Fernández Alfonso de Lossada Carmen Peral Mónica Valderrama Noelia Llevat María Montoro Álvarez Immaculada Calvo Penadés Real-World Health Care Outcomes and Costs Among Patients With Juvenile Idiopathic Arthritis in Spain Journal of Health Economics and Outcomes Research |
| title | Real-World Health Care Outcomes and Costs Among Patients With Juvenile Idiopathic Arthritis in Spain |
| title_full | Real-World Health Care Outcomes and Costs Among Patients With Juvenile Idiopathic Arthritis in Spain |
| title_fullStr | Real-World Health Care Outcomes and Costs Among Patients With Juvenile Idiopathic Arthritis in Spain |
| title_full_unstemmed | Real-World Health Care Outcomes and Costs Among Patients With Juvenile Idiopathic Arthritis in Spain |
| title_short | Real-World Health Care Outcomes and Costs Among Patients With Juvenile Idiopathic Arthritis in Spain |
| title_sort | real world health care outcomes and costs among patients with juvenile idiopathic arthritis in spain |
| url | https://doi.org/10.36469/001c.85088 |
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