The indirect costs of psoriatic arthritis: systematic review and meta-analysis

Abstract

The aim of this systematic review is to collect all current data on the indirect costs (IC) related to psoriatic arthritis (PsA). The search was conducted using MEDLINE (via PubMed), Embase and Centre for Reviews and Dissemination databases. We considered original studies, systematic reviews, economic evaluations, conference abstracts and posters. All collected data were recalculated to average annual cost per patient, expressed using the consumer price index for 2013 and converted to US dollars using purchasing power parity. Eight of the identified publications presented IC of PsA. Average annual IC per patient calculated using the friction cost approach range from US$1693.83 to $12,318.45, while using the human capital approach they range from US$1750.68 to $50,270.52. Result of the meta-analysis was a basis for calculating cost of work disability equaled US$10,754.04 per patient per year in 2013 prices. This systematic review revealed a great economic burden of the disease to the society. A small number of studies on IC in PsA justify further investigations.

Keywords:

• absenteeism
• cost of illness
• economic burden
• indirect cost
• presenteeism
• psoriatic arthritis
• sick leave
• systematic review

Financial & competing interests disclosure

The authors have no 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.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Psoriatic arthritis is one of the most prevalent inflammatory joint diseases which leads to severe pain, severe joint destruction, mutilating arthritis and comorbidities.

• Rheumatic diseases cause a great decrease in quality of life and huge socioeconomic burden in the form of absenteeism and presenteeism.

• A small number of identified studies and a great variety of considered components on indirect costs, estimation approaches and methodologies reflect that this issue is not yet fully examined.

• There is a great need of further studies focused on indirect costs in psoriatic arthritis to make possible to include a societal perspective into cost–effectiveness/utility analyses.

• Indirect costs data are difficult or just impossible to analyze. A better solution is to analyze the number of days that refer to absenteeism and presenteeism instead of indirect costs data.

• Costs of lost productivity range from US$1693.83 to $12318.45 (Friction Cost Approach) or from US$1750.68 to $50270.52 (Human Capital Approach) which can be a major part of total costs.