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Social/economic costs and health-related quality of life in patients with scleroderma in Europe

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Abstract

Objective

The aim of this study was to determine the economic burden from a societal perspective and the health-related quality of life (HRQOL) of patients with systemic sclerosis (SSc; scleroderma) in Europe.

Methods

We conducted a cross-sectional study of patients with SSc (involving both localised and systemic sclerosis) from Germany, Italy, Spain, France, the UK, Hungary and Sweden. Data on demographic characteristics, healthcare resource utilisation, informal care, labour productivity losses and HRQOL were collected from the questionnaires completed by patients or their caregivers. HRQOL was measured with the EuroQol 5-domain (EQ-5D) questionnaire.

Results

A total of 589 patients completed the questionnaire. The rate of patients with localised scleroderma, limited cutan and diffuse cutan SSc were 28, 68 and 4 %, respectively. Average annual costs varied from country to country and ranged from € 4607 to € 30,797 (reference year: 2012). Estimated direct healthcare costs ranged from € 1413 to € 17,300; direct non-healthcare costs ranged from € 1875 to € 4684 and labour productivity losses ranged from € 1701 to € 14,444. The mean EQ-5D index score for adult SSc patients varied from 0.49 to 0.75 and the mean EQ-5D visual analogue scale score was between 58.72 and 65.86.

Conclusion

The main strengths of this study lie in our bottom-up approach to costing and our evaluation of SSs patients from a broad societal perspective. This type of analysis is very unusual in the international literature on rare diseases in comparison with other illnesses. We concluded that SSc patients incur considerable societal costs and experience substantial deterioration in HRQOL.

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Acknowledgments

The authors wish to thank: National Alliance of People with Rare Diseases (NAPRD), Bulgaria; Alliance Maladies Rares, France; ACHSE, Germany; Hungarian Federation of People with Rare and Congenital Diseases (RIROSZ), Hungary; Federazione Italiana Malattie Rare (UNIAMO), Italy; the Consulta Nazionale delle Malattie Rare, Italy; Rare Diseases Sweden; Federación Española de Efermedades Raras (FEDER), Spain; Rare Disease UK and Rare Diseases Europe (EURORDIS); FESCA (Federation of European Scleroderma Associations); Association des Sclérodermiques de France; Sklerodermie Selbsthilfe e.V., Germany; Országos Scleroderma Közhasznú Egyesület, Hungary; AILS—Associazione italiana lotta alla Sclerodermia and As.MA.RA—Associazione malattia rara Sclerodermia ed altre malattie rare “Elisabetta Giuffre”, Italy; Reumatikerförbundet, Sweden; Asociación Española de Esclerodermia and Asociación de Esclerodermia de Castellón, Spain; Raynaud’s and Scleroderma Association and Scleroderma Society, UK. Juan Oliva-Moreno and Julio López-Bastida are also grateful for the support of the project ECO2013-48,217-C2-2-R, “Impacto económico, sanitario y social de las enfermedades y los problemas de salud: información y herramientas para la evaluación de políticas públicas—Socioeconomic and healthcare impact of health problems: information and tools for the evaluation of public policies”.

Author information

Authors and Affiliations

  1. Universidad de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain

    Julio López-Bastida

  2. Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain

    Julio López-Bastida, Renata Linertová, Juan Oliva-Moreno & Pedro Serrano-Aguilar

  3. Fundación Canaria de Investigación Sanitaria (FUNCANIS), Las Palmas de Gran Canaria, Spain

    Renata Linertová

  4. Universidad de Castilla-La Mancha, Toledo, Spain

    Juan Oliva-Moreno

  5. Evaluation and Planning Service at Canary Islands Health Service, Santa Cruz de Tenerife, Spain

    Pedro Serrano-Aguilar

  6. Instituto de Investigación en Enfermedades Raras (IIER), SpainRDR and CIBERER, Madrid, Spain

    Manuel Posada-de-la-Paz

  7. Health and Social Care Research Centre, London School of Economics and Political Science, London, UK

    Panos Kanavos

  8. National Center for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy

    Domenica Taruscio

  9. Centro di Ricerche Cliniche per Malattie Rare Aldo e Cele Daccò, Istituto di Ricerche Farmacologiche Mario Negri, Ranica (Bergamo), Italy

    Arrigo Schieppati

  10. Institute of Rare Diseases, Plovdiv, Bulgaria

    Georgi Iskrov

  11. Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria

    Georgi Iskrov

  12. Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary

    Márta Péntek

  13. Federación Española de Enfermedades Raras (FEDER), Madrid, Spain

    Claudia Delgado

  14. Centre for Health Economics Research Hannover (CHERH)/Institute for Risk and Insurance, Leibniz Universität Hannover, Hannover, Germany

    Johann Mathias von der Schulenburg

  15. Swedish Institute for Health Economics, Lund, Sweden

    Ulf Persson

  16. URC Eco Ile de France, AP-HP, Paris, France

    Karine Chevreul

  17. Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, Paris, France

    Karine Chevreul

  18. INSERM, ECEVE, U1123, Paris, France

    Karine Chevreul

  19. Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy

    Giovanni Fattore

Authors
  1. Julio López-Bastida
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  2. Renata Linertová
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  3. Juan Oliva-Moreno
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  4. Pedro Serrano-Aguilar
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  5. Manuel Posada-de-la-Paz
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  8. Arrigo Schieppati
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  9. Georgi Iskrov
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  11. Claudia Delgado
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  12. Johann Mathias von der Schulenburg
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  13. Ulf Persson
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  14. Karine Chevreul
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  15. Giovanni Fattore
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The BURQOL-RD Research Network

Corresponding author

Correspondence to Julio López-Bastida.

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Funding

Supported by the Social/Economic Burden and Health-Related Quality of Life in Patients with Rare Diseases in Europe Project, which received funding from the European Union within the framework of the Health Programme [grant A101205]. The Executive Agency of the European Union is not responsible for any use that may be made of the information contained herein.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Members of the BURQOL-RD Research Network listed in Annex I of the ESM.

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López-Bastida, J., Linertová, R., Oliva-Moreno, J. et al. Social/economic costs and health-related quality of life in patients with scleroderma in Europe. Eur J Health Econ 17 (Suppl 1), 109–117 (2016). https://doi.org/10.1007/s10198-016-0789-y

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