Indirect Costs of Rheumatoid Arthritis Depending on Type of Treatment—A Systematic Literature Review
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Absenteeism and Presenteeism
3.2. Overview of Indirect Costs
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
Appendix A
N. | Query | Items Found |
---|---|---|
#1 | adalimumab* OR Humira OR (D2E7 AND antibody) OR adalimumab [MeSH] | 6987 |
#2 | etanercept* OR Enbrel OR Erelzi OR Benepali OR (TNR–001 AND "fusion protein") OR etanercept [MeSH] | 7804 |
#3 | tocilizumab* OR RoActemra OR atlizumab OR tocilizumab [MeSH] | 2380 |
#4 | certolizumab* OR Cimzia OR (CDP870 OR CDP–870) OR certolizumab [MeSH] | 1072 |
#5 | rituximab* OR MabThera OR rituximab [MeSH] | 19,933 |
#6 | anakinra OR Kineret OR anakinra [Mesh] | 5464 |
#7 | abatacept OR Orencia OR abatacept [MeSH] | 3353 |
#8 | infliximab OR Remicade OR infliximab [MeSH] | 13,165 |
#9 | golimumab OR Simponi OR golimumab [MeSH] | 962 |
#10 | biologic* OR bio-logic* OR "bio logic*" OR biosimilar* OR bio-similar* or "bio similar*" | 1,735,869 |
#11 | #1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 | 1,776,784 |
#12 | "rheumatoid arthritis" OR RA | 159,750 |
#13 | #11 AND #12 | 19,542 |
#14 | (Indirect OR Productivity) AND (Cost OR Costs OR Cost* OR (Human AND Capital)) | 64,023 |
#15 | absenteeism OR presenteeism | 11,562 |
#16 | "human capital method"" OR HCM OR ""willingness to pay method"" OR WTP OR ""friction cost method"" OR FCM | 15,253 |
#17 | #13 AND (#14 OR #15 OR #16) | 153 |
Domain | BeST Allaart 2007 [22] | COMET Anis 2009 [23] |
---|---|---|
Random sequence generation | Unclear | Low |
Allocation concealment | Unclear | Low |
Blinding (participants and personnel) | High | Low |
Blinding (outcome assessment) | Low | Low |
Incomplete outcome data | Unclear | Unclear |
Selective reporting | High | Low |
Other sources of bias | Unclear | Low |
Quality Assessment | Zhang 2008 [24] | Augustsson 2010 [25] | Hone 2013 [26] | Klimes 2014 [27] | Tanaka 2018 [28] |
---|---|---|---|---|---|
Case series collected in more than one centre, i.e., multi-center study | Yes | Yes | Yes | No | Yes |
Is the hypothesis/aim/objective of the study clearly described? | Yes | Yes | Yes | No | Yes |
Are the inclusion and exclusion criteria (case definition) clearly reported? | Yes/No | Yes/No | Yes | No | Yes |
Is there a clear definition of the outcomes reported? | Yes | Yes | Yes | Yes | Yes |
Were data collected prospectively? | Yes | Yes | Yes | No | Yes |
Is there an explicit statement that patients were recruited consecutively? | Yes | Yes | Yes | Yes | Yes |
Are the main findings of the study clearly described? | Yes | Yes | Yes | Yes | Yes |
Are outcomes stratified? (e.g., by disease stage, abnormal test results, patient characteristics) | Yes | Yes | Yes | Yes | Yes |
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Author | Study Design | Treatment | n | Stage of RA | Age Range (Mean) | Disease Duration (Mean) | Absenteeism Measure | Presenteeism Measure | Method | Time Points |
---|---|---|---|---|---|---|---|---|---|---|
RCT Trials | ||||||||||
Allaart 2007 [22] | RCT (BeST) | 1. Seq. monotherapy | 508 | Early RA (ACR criteria) | ≥18 (ND) | ND | Three-monthly diary on work absenteeism | - | FCM | Baseline until 2 years |
2. Step-up comb. Therapy (INF) c | ||||||||||
3. Initial comb. Therapy (INF) d | ||||||||||
4. MTX + INF d | ||||||||||
Anis 2009 [23] | RCT (COMET) | MTX | 100 | Early RA (ACR criteria) | ≥18 (45.1) | 8.9 months | Number of missed work days/WPAI | Reduced working time (in days)/WLQ | HCM | 0 and 12 months (weeks 12, 24, 36, 52) |
ETA + MTX | 105 | ≥18 (45.4) | 8.6 months | Number of stopped work days f/WLQ | ||||||
Observational Studies | ||||||||||
Zhang 2008 [24] | Open-label, multicenter, phase IIIb study (CanAct) | ADA | 389 | Moderate to severe active RA (ACR criteria) | (55.0) | 12.5 years | Number of absent work days multiplied by the individual’s daily wage | Number of extra work hours patients needed to catch up on tasks they were unable to complete during normal working hours multiplied by the individual’s hourly wage | HCM | Baseline and 12 months |
Augustsson 2010 [25] | Observational (STURE register) | Anti-TNF (ETA, INF, ADA) | 594 | ND | 18–55 years (40.0) | 9.4 years | - | Hours worked/week | ND | Baseline, 6 months, 1, 2, 3, 4, and 5 years |
Hone 2013 [26] | Prospective, observational study | ETA | 204 | Moderate to severe RA | 20–67 (46.6) | 5.1 years | WPAI measures of absenteeism – work time missed | WPAI measures of presenteeism – impairment at work | HCM | 6 months |
Klimes 2014 [27] | Bottom-up cross-sectional cost-of-illness study | Without biologics | 137 | ND | 18–64 years (58.9) | 13.6 years | Days spent on sick leave, and the period of time spent on full disability pension or partial disability pension | - | FCM | 6 months |
With biologics | 124 | 18–64 years (53.6) | 15.5 years | |||||||
DMARDs | 130 | (53.7) | 10.1 months | |||||||
Tanaka 2018 [28] | Non-interventional trial for up-verified effects and utility (ANOUVEAU) study | ADA i | 1 196 | Greater portion of the patients had established RA, with moderate disease activity | PW: (50.0) | 5.6 years | WPAI measures of absenteeism—work time missed | WPAI measures of presenteeism—impairment at work | HCM | 48 weeks |
Author | Measure | Comparator | Difference | ∆ | 95%CI | Significant or Not | Costs |
---|---|---|---|---|---|---|---|
RCT Trials | |||||||
Anis 2009 [23] | Missed work days | MTX vs. ETA+MTX | 31.9 vs. 14.2 | −17.6 | (–34.4; –2.2) | YES | –£1244 c,f |
Reduced working time | 19.8 vs. 10.5 | –9.3 | (–21.9; 3.9) | NO | –£657 c,f | ||
Stopped worked days | Scenario Ic: 32.9 vs.10.9 Scenario IId: 12.3 vs. 4.8 | –22.1 –7.4 | (–45.2; –0.3) (–15.9; 1.2) | YES NO | Scenario I: –£1562 c,d,f Scenario II: –£523 c,e,f | ||
Total absenteeism | Scenario Ic: 65.6 vs.29.0 Scenario IId: 44.3 vs. 22.3 | −36.6 −22.0 | (−68.3; −5.9) (−42.6; –2.1) | YES YES | Scenario I: −£2586 c,d,f Scenario II: −£1555 c,e,f | ||
Allaart 2007 [21] | Overall | Decrease of 0.1 on utility associated with decrease of 2 working h/week | Using the friction-cost method, overall societal costs were estimated at €19,905, €15,926, €17,810, and €28,547 (p ≤ 0.05 Group 4 vs. Groups 1–3). Indirect costs: €9113, €8638, €10,001, and €4786 (Groups 1, 2, 3, and 4 respectively) a | ||||
4. MTX + INF | Productivity was highest in this group | ||||||
Observational Trials | |||||||
Zhang 2008 [24] | Absenteeism, mean | ADA vs. baseline | ND | ND | ND | ND | Lost productivity costs, past two weeks: –$57.21 (mean) |
Hone 2013 [26] | Hours gained/patient (absenteeism) | ETA baseline vs. 6 months | 71.1 vs. 63.5/ 9.9 ± 20.1 vs. 4.4 ± 16.1 | 7.6/ −3.5 ± 17.0 | ND/ (−6.1; −1.0) | ND/ YES | Economic gain/patient: $1794 |
Klimes 2014 [27] | Productivity costs | Without vs. with biological treatment | ND | ND | ND | ND | Friction cost approach: €1304 vs. €2090 |
Tanaka 2018 [28] | Absenteeism | Baseline vs. week 48 | ND | ND | ND | ND | Human capital method (cumulative reduction): PW: $9278 (mean) PTW: $6480 (mean) HM: $5449 (mean) |
Author | Measure | Comparator | Difference | ∆ | 95%CI | Significant or Not | Costs |
---|---|---|---|---|---|---|---|
RCT Trial | |||||||
Anis 2009 [23] | WPAI: Work productivity loss at work (%) | MTX vs. ETA + MTX | 23.1 vs. 15.6 | −7.5 | (−11.2; −4.2) | YES | NA |
WPAI: Lost work days due to presenteeism | Scenario I: 34.0 vs. 28.6 Scenario II: 38.9 vs. 29.7 | −5.4 −9.3 | (−13.5; 2.8) (−16.3; −2.5) | NO YES | −£382 −£657 | ||
WPAI: Total work productivity loss, days | Scenario I: 99.6 vs. 57.6 Scenario II: 83.3 vs. 51.9 | −42.0 −31.3 | (−69.0; −15.7) (−50.2; −12.6) | YES YES | −£2968 −£2212 | ||
WLQ: work productivity loss at work (%) | 6.2 vs. 4.8 | −1.4 | (−2.1; −0.7) | YES | NA | ||
WLQ: Lost work days due to presenteeism | Scenario I: 9.1 vs. 8.9 Scenario II: 10.4 vs. 9.2 | −0.3 −1.3 | (−2.3; 1.8) (−2.8; 0.3) | NO NO | −£21 −£92 | ||
WLQ: Total work productivity loss, days | Scenario I: 74.7 vs. 37.8 Scenario II: 54.8 vs. 31.5 | −36.9 −23.3 | (−66.9; −7.6) (−43.0; −4.2) | YES YES | −£2607 −£1646 | ||
Observational trials | |||||||
Zhang 2008 [24] | Absenteeism, mean | ADA vs. baseline | ND | ND | ND | ND | Lost productivity costs, past two weeks: –$4.48 |
Augustsson 2010 [25] | Overall | Unadjusted model | Improvement: first year: 4.2 h/week, thereafter: 0.5 h/week | The productivity gains for society in patients continuing treatment would total €28,000 over 5 years. | Note that these estimates only apply to patients who do not discontinue treatment, a group that may be difficult to identify before treatment initiation. | ||
Adjusted model b | Improvement: first year: 4.1 h/week, thereafter: no change | The productivity gains for society in patients continuing treatment would total €27,000 over 5 years. This corresponds to approximately 40% of the annual anti-TNF drug cost. | |||||
Hone 2013 [26] | Hours gained/patient (presenteeism) | ETA baseline vs. 6 months | 205.2 vs. 189.7/ 39.7 ± 24.5 vs. 24.8 ± 22.5 | 15.5/ −13.5 ± 23.3 | ND/ (−17.0; −9.9) | ND/ YES | Economic gain/patient: $5328 |
Tanaka 2018 [28] | Presenteeism | Baseline vs. week 48 | ND | ND | ND | ND | Human capital method (cumulative reduction): PW: $5836 (mean) PTW: $2726 (mean) HM: NA |
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Batko, B.; Rolska-Wójcik, P.; Władysiuk, M. Indirect Costs of Rheumatoid Arthritis Depending on Type of Treatment—A Systematic Literature Review. Int. J. Environ. Res. Public Health 2019, 16, 2966. https://doi.org/10.3390/ijerph16162966
Batko B, Rolska-Wójcik P, Władysiuk M. Indirect Costs of Rheumatoid Arthritis Depending on Type of Treatment—A Systematic Literature Review. International Journal of Environmental Research and Public Health. 2019; 16(16):2966. https://doi.org/10.3390/ijerph16162966
Chicago/Turabian StyleBatko, Bogdan, Paulina Rolska-Wójcik, and Magdalena Władysiuk. 2019. "Indirect Costs of Rheumatoid Arthritis Depending on Type of Treatment—A Systematic Literature Review" International Journal of Environmental Research and Public Health 16, no. 16: 2966. https://doi.org/10.3390/ijerph16162966