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Social and economic costs and health-related quality of life in non-institutionalised patients with cystic fibrosis in the United Kingdom.

Angelis A, Kanavos P, López-Bastida J, Linertová R, Nicod E, Serrano-Aguilar P, BURQOL-RD Research Netwo - BMC Health Serv Res (2015)

Bottom Line: The results highlight that beyond conventional costs such as acute hospitalisations, medication and outpatient and primary care visits, indirect costs related to informal care and early retirement, have significant societal implications.Similarly, our analysis showed that the average EQ-5D index score of adult CF patients was significantly lower than in the general population, an indication that a methodological bias may exist in using the latter in economic analyses.CF poses a significant cost burden on UK society, with non-health care and indirect costs representing 57 % of total average costs, and HRQOL being considerably lower than in the general population.

View Article: PubMed Central - PubMed

Affiliation: Department of Social Policy and LSE Health, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, England. a.n.angelis@lse.ac.uk.

ABSTRACT

Background: This study aimed to determine the societal economic burden and health-related quality of life (HRQOL) of cystic fibrosis (CF) patients in the UK.

Methods: A bottom-up cost-of-illness, cross-sectional, retrospective analysis of 74 patients was conducted aiming to estimate the economic impact of CF. Data on demographic characteristics, health resource utilisation, informal care, productivity losses and HRQOL were collected from questionnaires completed by patients or their caregivers. HRQOL was measured with the EuroQol 5-domain (EQ-5D) instrument.

Results: Using unit costs for 2012 we found that the average annual cost for a CF patient was €48,603, with direct health care costs amounting to €20,854 (42.9 % of total costs), direct non-health care costs being €21,528 (44.3 %) and indirect costs attributable to productivity losses being €6,222 (12.8 %). On average, the largest expenditures by far were accounted for by informal care (44.1 %), followed by medications (14.5 %), acute hospitalisations (13.9 %), early retirement (9.1 %) and outpatient and primary health care visits (7.9 %). Sharp differences existed depending on whether CF patients were in need of caregiver help (€76,271 versus €26,335). In adult CF patients, mean EQ-5D index scores were 0.64 (0.93 in the general population) and mean EQ-5D visual analogue scale scores were 62.23 (86.84 in the general population); among caregivers, these scores were 0.836 and 80.85, respectively.

Discussion: Our analysis highlights the importance of the economic and quality of life consequences of CF from a societal perspective. The results highlight that beyond conventional costs such as acute hospitalisations, medication and outpatient and primary care visits, indirect costs related to informal care and early retirement, have significant societal implications. Similarly, our analysis showed that the average EQ-5D index score of adult CF patients was significantly lower than in the general population, an indication that a methodological bias may exist in using the latter in economic analyses.

Conclusion: CF poses a significant cost burden on UK society, with non-health care and indirect costs representing 57 % of total average costs, and HRQOL being considerably lower than in the general population.

No MeSH data available.


Related in: MedlinePlus

Breakdown of costs according to all CF patients, CF patients with carers, and CF patients without carers (2012, €)
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Fig1: Breakdown of costs according to all CF patients, CF patients with carers, and CF patients without carers (2012, €)

Mentions: Estimated average annual cost per patient in 2012 was €48,603, and the median was €34,883 (Table 2). Direct non-health care cost was the largest component (44.3 % of the total average cost per patient), followed by direct health care costs (42.9 %) and productivity loss (12.8 %) (Fig. 1). The most important categories of health care costs were medications, (33.8 % of health care and 14.5 % of total costs), followed by acute hospitalizations (32.4 % of health care and 13.9 % of total costs) and outpatient and primary health care visits (18.3 % of health costs and 7.9 % of total costs) (Fig. 2). The most relevant category of direct non-health care cost was informal care, averaging €21,447 (99.6 % of direct non-health care and 44.1 % of total costs), with a special mention given to the cost related to main caregivers (75.8 % of direct non-health care cost and 33.6 % of total costs). Social services only accounted for 0.2 % of direct non-health care cost and 0.1 % of total costs, and non-health care transport represented 0.2 % of direct non-health costs and 0.1 % of total costs respectively. Finally, sick leave accounted for 29 % of productivity loss and 3.7 % of total costs, whereas early retirement accounted for 71 % of productivity loss and 9.1 % of total costs.Table 2


Social and economic costs and health-related quality of life in non-institutionalised patients with cystic fibrosis in the United Kingdom.

Angelis A, Kanavos P, López-Bastida J, Linertová R, Nicod E, Serrano-Aguilar P, BURQOL-RD Research Netwo - BMC Health Serv Res (2015)

Breakdown of costs according to all CF patients, CF patients with carers, and CF patients without carers (2012, €)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4587726&req=5

Fig1: Breakdown of costs according to all CF patients, CF patients with carers, and CF patients without carers (2012, €)
Mentions: Estimated average annual cost per patient in 2012 was €48,603, and the median was €34,883 (Table 2). Direct non-health care cost was the largest component (44.3 % of the total average cost per patient), followed by direct health care costs (42.9 %) and productivity loss (12.8 %) (Fig. 1). The most important categories of health care costs were medications, (33.8 % of health care and 14.5 % of total costs), followed by acute hospitalizations (32.4 % of health care and 13.9 % of total costs) and outpatient and primary health care visits (18.3 % of health costs and 7.9 % of total costs) (Fig. 2). The most relevant category of direct non-health care cost was informal care, averaging €21,447 (99.6 % of direct non-health care and 44.1 % of total costs), with a special mention given to the cost related to main caregivers (75.8 % of direct non-health care cost and 33.6 % of total costs). Social services only accounted for 0.2 % of direct non-health care cost and 0.1 % of total costs, and non-health care transport represented 0.2 % of direct non-health costs and 0.1 % of total costs respectively. Finally, sick leave accounted for 29 % of productivity loss and 3.7 % of total costs, whereas early retirement accounted for 71 % of productivity loss and 9.1 % of total costs.Table 2

Bottom Line: The results highlight that beyond conventional costs such as acute hospitalisations, medication and outpatient and primary care visits, indirect costs related to informal care and early retirement, have significant societal implications.Similarly, our analysis showed that the average EQ-5D index score of adult CF patients was significantly lower than in the general population, an indication that a methodological bias may exist in using the latter in economic analyses.CF poses a significant cost burden on UK society, with non-health care and indirect costs representing 57 % of total average costs, and HRQOL being considerably lower than in the general population.

View Article: PubMed Central - PubMed

Affiliation: Department of Social Policy and LSE Health, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, England. a.n.angelis@lse.ac.uk.

ABSTRACT

Background: This study aimed to determine the societal economic burden and health-related quality of life (HRQOL) of cystic fibrosis (CF) patients in the UK.

Methods: A bottom-up cost-of-illness, cross-sectional, retrospective analysis of 74 patients was conducted aiming to estimate the economic impact of CF. Data on demographic characteristics, health resource utilisation, informal care, productivity losses and HRQOL were collected from questionnaires completed by patients or their caregivers. HRQOL was measured with the EuroQol 5-domain (EQ-5D) instrument.

Results: Using unit costs for 2012 we found that the average annual cost for a CF patient was €48,603, with direct health care costs amounting to €20,854 (42.9 % of total costs), direct non-health care costs being €21,528 (44.3 %) and indirect costs attributable to productivity losses being €6,222 (12.8 %). On average, the largest expenditures by far were accounted for by informal care (44.1 %), followed by medications (14.5 %), acute hospitalisations (13.9 %), early retirement (9.1 %) and outpatient and primary health care visits (7.9 %). Sharp differences existed depending on whether CF patients were in need of caregiver help (€76,271 versus €26,335). In adult CF patients, mean EQ-5D index scores were 0.64 (0.93 in the general population) and mean EQ-5D visual analogue scale scores were 62.23 (86.84 in the general population); among caregivers, these scores were 0.836 and 80.85, respectively.

Discussion: Our analysis highlights the importance of the economic and quality of life consequences of CF from a societal perspective. The results highlight that beyond conventional costs such as acute hospitalisations, medication and outpatient and primary care visits, indirect costs related to informal care and early retirement, have significant societal implications. Similarly, our analysis showed that the average EQ-5D index score of adult CF patients was significantly lower than in the general population, an indication that a methodological bias may exist in using the latter in economic analyses.

Conclusion: CF poses a significant cost burden on UK society, with non-health care and indirect costs representing 57 % of total average costs, and HRQOL being considerably lower than in the general population.

No MeSH data available.


Related in: MedlinePlus