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Modeling the progression of rheumatoid arthritis - A two-country model to estimate costs and consequences of rheumatoid arthritis

Kobelt, G; Jonsson, L; Lindgren, P; Young, A and Eberhardt, Kerstin LU (2002) In Arthritis and Rheumatism 46(9). p.2310-2319
Abstract
Objective. Two simulation models were developed to analyze the cost-effectiveness of new treatments that affect the progression of rheumatoid arthritis (RA). Methods. We used data from 2 cohorts of. patients with early RA who had been followed up since disease onset (up to 15 years). In the Swedish study, 183 patients were followed up for a mean of 11.3 years. In the UK study, 916 patients were followed up for a mean of 7.8 years. Disease progression over 10 years was modeled as annual transitions between disease states, defined by Health Assessment Questionnaire (HAQ) scores. A regression model was used to estimate transition probabilities conditional on age, sex, and time since onset of disease, in order to allow simulation of different... (More)
Objective. Two simulation models were developed to analyze the cost-effectiveness of new treatments that affect the progression of rheumatoid arthritis (RA). Methods. We used data from 2 cohorts of. patients with early RA who had been followed up since disease onset (up to 15 years). In the Swedish study, 183 patients were followed up for a mean of 11.3 years. In the UK study, 916 patients were followed up for a mean of 7.8 years. Disease progression over 10 years was modeled as annual transitions between disease states, defined by Health Assessment Questionnaire (HAQ) scores. A regression model was used to estimate transition probabilities conditional on age, sex, and time since onset of disease, in order to allow simulation of different patient cohorts. Costs and utilities associated with different HAQ levels were based on data from the cohort studies and cross-sectional surveys. Results. Costs increase and quality of life decreases as RA progresses. In Sweden, total annual costs range from $4,900 to $33,000 per patient, compared with $4,900 to $14,600 in the UK. Cumulative costs over 10 years for patients starting in disease state 1 (HAQ < 0.6) are $54,600 in Sweden and $26,600 in the UK. The cumulative numbers of quality-adjusted life-years (QALYs) are 5.5 and 5.6, respectively. Both costs and QALYs were discounted at 3%. Conclusion. The 2 models, which were based on different patient cohorts, reach a similar conclusion in terms of the effect of RA over 10 years. They appear to accurately capture disease progression and its effects and can therefore be useful in estimating the cost-effectiveness of new treatments in RA. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Arthritis and Rheumatism
volume
46
issue
9
pages
2310 - 2319
publisher
John Wiley & Sons
external identifiers
  • wos:000178421500006
  • pmid:12355478
  • scopus:0036746102
ISSN
1529-0131
DOI
10.1002/art.10471
language
English
LU publication?
yes
id
de2ef0fe-7ea4-4fbf-8b27-0792e287999a (old id 326225)
date added to LUP
2007-10-29 15:10:09
date last changed
2017-10-29 03:41:02
@article{de2ef0fe-7ea4-4fbf-8b27-0792e287999a,
  abstract     = {Objective. Two simulation models were developed to analyze the cost-effectiveness of new treatments that affect the progression of rheumatoid arthritis (RA). Methods. We used data from 2 cohorts of. patients with early RA who had been followed up since disease onset (up to 15 years). In the Swedish study, 183 patients were followed up for a mean of 11.3 years. In the UK study, 916 patients were followed up for a mean of 7.8 years. Disease progression over 10 years was modeled as annual transitions between disease states, defined by Health Assessment Questionnaire (HAQ) scores. A regression model was used to estimate transition probabilities conditional on age, sex, and time since onset of disease, in order to allow simulation of different patient cohorts. Costs and utilities associated with different HAQ levels were based on data from the cohort studies and cross-sectional surveys. Results. Costs increase and quality of life decreases as RA progresses. In Sweden, total annual costs range from $4,900 to $33,000 per patient, compared with $4,900 to $14,600 in the UK. Cumulative costs over 10 years for patients starting in disease state 1 (HAQ &lt; 0.6) are $54,600 in Sweden and $26,600 in the UK. The cumulative numbers of quality-adjusted life-years (QALYs) are 5.5 and 5.6, respectively. Both costs and QALYs were discounted at 3%. Conclusion. The 2 models, which were based on different patient cohorts, reach a similar conclusion in terms of the effect of RA over 10 years. They appear to accurately capture disease progression and its effects and can therefore be useful in estimating the cost-effectiveness of new treatments in RA.},
  author       = {Kobelt, G and Jonsson, L and Lindgren, P and Young, A and Eberhardt, Kerstin},
  issn         = {1529-0131},
  language     = {eng},
  number       = {9},
  pages        = {2310--2319},
  publisher    = {John Wiley & Sons},
  series       = {Arthritis and Rheumatism},
  title        = {Modeling the progression of rheumatoid arthritis - A two-country model to estimate costs and consequences of rheumatoid arthritis},
  url          = {http://dx.doi.org/10.1002/art.10471},
  volume       = {46},
  year         = {2002},
}