Research ArticlePsoriatic Arthritis

Evaluation of the Economic Burden of Psoriatic Arthritis and the Relationship Between Functional Status and Healthcare Costs

Neil McHugh, Áine Maguire, Ian Handel, William Tillett, James Morris, Neil Hawkins, Charlotte Cavill, Eleanor Korendowych and Farhan Mughal
The Journal of Rheumatology May 2020, 47 (5) 701-707; DOI: https://doi.org/10.3899/jrheum.190083

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Tables

  • Table 1.

    Patient characteristics.

    CharacteristicsStudy Population
    Patients, N101
    Age, yrs, mean (SD)57.83 (10.66)
    Sex, female/male, n (%)58 (57)/43 (43)
    HAQ-DI score, mean (SD)0.84 (0.75)
    Disease duration, yrs, mean (SD)18.23 (11.26)

    • HAQ-DI: Health Assessment Questionnaire-Disability Index.

  • Table 2.

    Healthcare costs per patient* by resource use category (£/unit, 2016 prices).

    Resource Use CategoryMean (SD)Median (IQR)Range
    Tests£146 (£117)£126 (£137)£0–£690
    A&E visit£14 (£35)£0 (£0)£0–£154
    Primary care consultation£247 (£198)£195 (£256)£0–£1101
    Secondary care consultation£678 (£445)£594 (£445)£0–£2635
    Admitted care£502 (£1415)£0 (£0)£0–£6660
    Medication costs£2284 (£3493)£390 (£3560)£0–£16,326
    Total costs£3870 (£3986)£2123 (£4952)£175–£17,771
    Total costs (excluding medication costs)£1586 (£1639)£1111 (£1213)£174–£8854

    • ↵* Based on study population of 101 patients, the n values used to calculate values shown may vary slightly across cost categories because of missing data. A&E: accident and emergency department; IQR: interquartile range.

  • Table 3.

    Output results of the linear regression modeling.

    Covariatesβ (SE)p95% CI for β
    HAQ-DI total cost (excluding medications)£547 (£224)0.006197–1120
    Intercept total cost (excluding medications)£1128 (£200)< 0.001792–1596
    No. observations101
    Log likelihood−887.1
    Adjusted R20.053

    • HAQ-DI: Health Assessment Questionnaire-Disability Index; SE: standard error.

  • Table 4.

    Results of the regression modeling: estimated HAQ-DI coefficient.

    AnalysesEstimated HAQ-DI Coefficient from Regression of Costs in HAQ-DI (£/unit)
    Estimate (SE)*95% CIp
    Primary analysis
      Tests£21.45 (£14)−7 to 480.121
      A&E visit£15.67 (£6)7 to 290.001
      Primary care consultation£69.98 (£25)21 to 1170.007
      Secondary care consultation£278.14 (£50)185 to 381< 0.001
      Medications£58.07 (£447)−788 to 9660.903
      Admitted care£162.25 (£200)−131 to 7160.437
      Total costs (w/o meds)£547.49 (£224)197 to 11200.006
    Sensitivity analyses for total costs (excluding medication cost)
      Disease duration, yrs
        0 to < 5 (n = 6)£−76.97 (£499)−1335 to 7790.852
        5 to < 10 (n = 12)£390.47 (£834)−275 to 41180.656
        ≥ 10 (n = 63)£626.50 (£264)212 to 12980.008
      HAQ-DI
        0 to < 1 (n = 58)£981.68 (£572)−15 to 22630.066
        1 to < 2 (n = 33)£116.88 (£904)−2066 to 16150.849
        ≥ 2 (n = 10)£3340.13 (£3693)883 to 15,3030.051
      Sex
        Female (n = 58)£480.3 (£377)−123 to 14070.208
        Male (n = 43)£520.92 (£264)148 to 12730.014

    • ↵* Bootstrapped SE. A&E: accident and emergency department; HAQ-DI: Health Assessment Questionnaire–Disability Index; SE: standard error.

  • Primary AnalysisEstimated HAQ-DI Coefficient from Regression of Costs in HAQ-DI (£/unit)
    Estimate (SE)*95% CIp
    Tests£18.19 (£15)−12 to 460.209
    A&E visit£17.27 (£6)7 to 310.001
    Primary care consultation£67.26 (£27)14 to 1190.015
    Secondary care consultation£264.55 (£51)170 to 369< 0.001
    Medications£−57.78 (£439)−873 to 8570.884
    Admitted care£18.86 (£48)−101 to 970.654
    Total costs (without medication)£386.13 (£93)202 to 566< 0.001

    • A&E: accident and emergency department; HAQ-DI: Health Assessment Questionnaire–Disability Index; SE: standard error.

  • VariablesEstimated HAQ-DI Coefficient from Regression of log10 (costs + 1) in HAQ-DI (£/unit)
    Estimate (SE)*Estimate ^10 (CI)p
    Tests0.129 (0.066)1.344 (0.966–1.814)0.053
    A&E visit0.300 (0.089)1.997 (1.331–2.995)0.001
    Primary care consultation0.130 (0.070)1.350 (0.981–1.856)0.065
    Secondary care consultation0.147 (0.050)1.403 (1.116–1.764)0.004
    Medications0.073 (0.128)1.182 (0.660–2.118)0.571
    Admitted care0.275 (0.173)1.882 (0.854–4.149)0.116
    Total costs (without medication)0.172 (0.042)1.485 (1.223–1.803)< 0.001

    • A&E: accident and emergency department; HAQ-DI: Health Assessment Questionnaire–Disability Index; SE: standard error.

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Keywords

PSORIATIC ARTHRITIS
ECONOMIC BURDEN OF DISEASE
HEALTHCARE COSTS
REGRESSION ANALYSIS

Keywords