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. 2021 Apr 21:17:345-356.
doi: 10.2147/TCRM.S301005. eCollection 2021.

Utilization of Healthcare Resources in Osteoarthritis: A Cost of Illness Analysis Based on Real-World Data in Italy

Giorgio Lorenzo Colombo  1 , Franca Heiman  2 , Ilaria Peduto  2
Affiliations

Utilization of Healthcare Resources in Osteoarthritis: A Cost of Illness Analysis Based on Real-World Data in Italy

Giorgio Lorenzo Colombo et al. Ther Clin Risk Manag. .

Abstract

Purpose: Understand the demographics and clinical features of patients with osteoarthritis (OA), quantify healthcare resource utilization by OA patients, and estimate the annual direct medical costs per OA patient from a National Health Service (NHS) perspective in Italy.

Patients and methods: Retrospective observational cohort analysis using data from electronic medical records captured by the Italian IQVIA Longitudinal Patient Database (LPD). Only direct medical costs reimbursed by the NHS were considered. Patients were included if they received at least one diagnosis of OA during the period from January 1 to December 31, 2018. Each patient was observed for 3 years: a 24-month baseline period preceding the index date, and a 12-month follow-up period starting at the index date.

Results: A total of 71,467 patients met inclusion criteria: 43.98% had not been prescribed NSAIDs/opioids, 40.76% had been prescribed NSAIDs, and 15.26% an opioid. Mean age was 71.36 years, and 68.2% of the patients were women. At least one comorbidity was present in 91.34% of the patients; 38.05% were newly diagnosed with OA. During 1-year of follow-up, 173,884 prescriptions with an associated diagnosis of OA were found: 47.36% had been prescribed an NSAID, 9.11% diclofenac, 8.30% codeine+paracetamol, and 7.32% ketoprofen. Nearly 15% of the patients had at least 1 request for a specialist visit and 23.82% had at least 1 request for exams. Orthopedic visits accounted for 60% of all specialist visits. Yearly mean costs per patient were €622, for approximately €2.5 billion per year in direct costs, considering 3.9 million patients with OA in Italy. Protheses were a major driver in annual costs: €143.45 in patients without a prosthesis and €10,090.91 in those with a joint prosthesis.

Conclusion: This real-world analysis of direct costs of care of patients with OA in Italy confirms the substantial economic burden. Direct costs dramatically increased when joint replacement was needed.

Keywords: Italy; costs; osteoarthritis; real-world.

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Conflict of interest statement

Franca Heiman and Ilaria Peduto are employees of IQVIA which received financial support to develop this manuscript. Giorgio Lorenzo Colombo has received speaker fees, research and educational grants from Abbott, Amgen, EISAI, Jazzpharma, LEO Pharma, Novo Nordisk, Merck Sharp and Dompé, Menarini, Otsuka and Pfizer. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Selection of the patient population.
Figure 2
Figure 2
Number of comorbidities per patient, stratified by pharmaceutical treatment for OA during follow-up.
Figure 3
Figure 3
Mean annual costs per patient, stratified by type of cost and pharmaceutical treatment for OA during follow-up.
Figure 4
Figure 4
Distribution of costs in patients with and without a joint prosthesis.
See this image and copyright information in PMC

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