How Do PROs Impact the Economic Burden of Ankylosing Spondylitis?

Recent findings indicate greater functional impairment could be associated with increased health care resource utilization (HCRU) for patients with ankylosing spondylitis (AS) in the United States.

Researchers conducted a cohort study of 334 patients with AS to better understand the association of patient-reported outcome (PRO) measures and the economic burden. Eligible participants had an AS diagnosis and were enrolled in the FORWARD registry from July 2009 to June 2019, completed 1 questionnaire between January 2010 to December 2019, and completed either the Health Assessment Questionnaire Disability Index (HAQ-DI) (0-3) and/or Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (0-10).

Patient-reported data related to outcomes, demographics, and clinical characteristics were collected biannually via additional questionnaires.

Patient-reported HCRU and costs for hospitalizations, emergency department (ED) visits, outpatient visits, diagnostic tests, and procedures were recorded for 6 months prior to the latest questionnaire and adjusted for 2019 US dollars.

“The mean (SD) HAQ-DI and BASDAI scores at the time of patients’ most recent surveys were 0.9 (0.7) and 3.7 (2.3), respectively,” explained authors. “HAQ-DI score was positively associated with number of hospitalizations, ED visits, outpatient visits, and diagnostic tests, whereas BASDAI was not associated with HCRU outcomes.”

In terms of total health care, medical, and pharmacy costs for patients with AS, mean costs were found to be $44,783 ($40,595); $6,521 ($12,733); and $38,263 ($40,595), respectively.

Additionally, for each 1.0-unit increase in HAQ-DI score, annualized total health care costs adjusted for confounders increased by 35%. Medical and pharmacy costs increased by 76% and 26%, respectively.

“Higher HAQ-DI scores were associated with higher HCRU and total health care costs among patients with AS in FORWARD, but BASDAI scores were not,” concluded authors. “These findings indicate that greater functional impairment may impose an increased economic burden compared with other patient-reported measures of AS.”

Reference:
Ogdie A, Hwang M, Verranki P, et al. Association of health care utilization and costs with patient-reported outcomes in patients with ankylosing spondylitis. J Manag Care Spec Pharm. 2022;28(9):1008-1020. doi:10.18553/jmcp.2022.28.9.1008