Disease burden on health care by pain severity and usual analgesic treatment in patients with symptomatic osteoarthritis: a Spanish nationwide health survey

ABSTRACT

Background

Osteoarthritis (OA) pain is a health care highly demanding and costing condition.

Objective

To estimate disease burden on health care in OA in Spain, determining whether burden differs by pain severity and usual analgesic treatment.

Methods

A cross-sectional design using the 2017-Spanish-National-Health-Survey was used to abstract data of 5,234 adult patients (women 70.8%; 69.9 years) with a self-reported physician OA diagnosis. Patients were assembled according to pain severity (no/mild, moderate, severe) and use of usual analgesia (treated [66.5%]/untreated). Healthcare resource utilization (HRU) and corresponding costs were expressed Per-Patient-Per-Year (PPPY) and adjusted for covariates.

Results

Average (SD) healthcare cost was €2,274 (5,461) PPPY, with costs linked to outpatient medical visits being the major driver; ~43%. Adjusted PPPY medical visits, days of hospitalization, other healthcare visits, and corresponding costs were significantly higher in severe pain OA patients, compared to moderate or mild/no pain regardless of being currently treated with usual analgesics or not (p < 0.001). Treated OA patients showed higher HRU and costs than untreated patients.

Conclusions

Severity of pain was the main driver of HRU and costs in OA patients from a nationwide representative survey in Spain. These findings seem to be more consistent in treated versus not treated patients with usual analgesics.

KEYWORDS:

• Osteoarthritis
• burden
• treated
• pain
• healthcare resource utilization
• costs

Acknowledgments

Preliminary findings have been submitted to the year 2020 WCO-IOF-ESCEO. Congress to be held next August 20–23, 2020 in Barcelona, Spain.

Author contributions

The idea of the work was originally developed by Javier Rejas-Gutiérrez (JRG) and Josep Darbà (JD). Data abstraction from Spanish National Health Survey and cost databases was carried out by Natalia Llopart-Carles (NLC) and Sofía García-López (SGL), together with bibliography review. The analysis was performed by JR and supervised by JD. NLC and SGL participated in some part of the analysis. A preliminary manuscript was written by NLC and SGL. JR drafted the manuscript in full and elaborated the final version after including the contribution of coauthors. All coauthors reviewed the manuscript and made meaningful contributions. All of the authors approved its contents and agreed to be submitted for publication.

Consent to participate

The confidentiality of the (anonymous and dissociated) records was respected in accordance with the existing Law on Personal Data Protection in Spain (Law 15/1999, of 13 December 1999, on Personal Data Protection). Individuals included in the ENSE survey participated voluntarily and gave their personal consent prior to their participation in the survey (see details on survey implementation at https://www.mscbs.gob.es/estadEstudios/estadisticas/encuestaNacional/encuesta2017.htm).

Consent for publication

The manuscript has been read and approved by all authors who also meet the requirements for authorship. All of them agreed to submit the manuscript for publication, and that decision pertains solely to all authors.

Declaration of interest

Javier Rejas-Gutiérrez is an employee of Pfizer, SLU in Spain, but this entity did not provide any funding to this manuscript and/or analysis of data. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Ethics approval

The analysis performed in this study used aggregate dated available in the public domain only; thus, de-identification was guaranteed to prevent anyone’s personal identity from being revealed. Therefore, studies as this one are exempt from IRB submission or classification by the Spanish Agency for Medicines and Medical Devices (AEMPS) according to current regulations for post-authorization observational studies (https://www.aemps.gob.es/investigacionClinica/medicamentos/estudiosPostautorizacion.htm#norEstatal).

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This paper was not funded.