direct cost; indirect cost; osteoporosis; workplace
Abstract :
[en] Introduction: The objective of this study was to estimate the direct and indirect costs attributable to osteoporosis (OP) from a societal and a payer's perspective among active subjects living in Belgium and employed in the public workforce. Materials and methods: A cohort of 3440 subjects employed by the Liege City Council was followed for 6 months. The City Council employees were invited to fill a monthly log of the data related to their utilization of health resources ( contacts with health professionals, medical examinations, drug use,...) due to OP. Information on work disability ( number of days of sick leave) and on informal care ( number of days off work incurred by active subjects in helping relatives or friends suffering from OP) was also collected. Results: Of those asked to participate in the study, 1,811 subjects filled in at least one questionnaire. The mean duration of follow-up was 3.46 months. Self-reported prevalence of OP at inclusion was 5.3%. OP subjects were significantly older (52.7 +/- 6.1 years) than normal subjects (45.5 +/- 9.8 years) ( p< 0.05) and included more women (85.3 vs. 55.9%). Direct costs came to E44.6 per OP patient-month: E10.9 was spent on contact with health professionals, E19.0 on medical examinations, E12.1 on drugs and E2.6 on hospitalizations. During this 6-month study, a total of 140 days of sick leave was recorded ( mean: 0.4 per OP patient-month). From a payer's perspective, this loss in productivity yielded a mean cost of E34.05 per OP patient-month. A mean number of days off work of 0.018 per active subject-month, attributable to informal care, was recorded. These days of inactivity represented, for the employer, a mean cost of E1.8 per active subject-month. Conclusion: The results of this survey of a large sample of active subjects confirm that OP-related expenditures, both for medical care and for loss of productivity, are significant.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Rabenda, Véronique ; Université de Liège - ULiège > Département des sciences de la santé publique > Epidémiologie et santé publique
Manette, C.
Lemmens, R.
Mariani, A. M.
Struvay, N.
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique > Epidémiologie et santé publique
Language :
English
Title :
The direct and indirect costs of the chronic management of osteoporosis: a prospective follow-up of 3440 active subjects
Reginster JY (2004) Prevention of postmenopausal osteoporosis with pharmacological therapy: practice and possibilities. J Intern Med 255(6):615-628
Chrischilles E, Shireman T, Wallace R (1994) Costs and health effects of osteoporotic fractures. Bone 15(4):377-386
Randell A, Sambrook PN, Nguyen TV, Lapsley H, Jones G, Kelly PJ, Eisman JA (1995) Direct clinical and welfare costs of osteoporotic fractures in elderly men and women. Osteoporos Int 5(6):427-432
Levy E (1989) Cost analysis of osteoporosis related to untreated menopause. Clin Rheumatol 8[Suppl 2]:76-82
Reginster JY, Gillet P, Ben Sedrine W, Brands G, Ethgen O, de Froidmont C, Gosset C (1999) Direct costs of hip fractures in patients over 60 years of age in Belgium. Pharmacoeconomics 15(5):507-514
Osteoporosis in the workplace: The social, economic and human costs of osteoporosis on employees, employers and governments. Prepared by the World Health Organization Collaborating Center, Liege, Belgium, on behalf of the IOF Committee of Scientific Advisors (2002) Available at:http: //www.osteofound.org
Reginster JY, Deroisy R, Pirenne H, Frederick I, Dewe W, Albert A et al .(1999) High prevalence of low femoral bone mineral density in elderly women living in nursing homes or community-dwelling : a plausible role of increased parathyroid hormone secretion. Osteoporos Int 9:121-128
Richy F, Ethgen O, Bruyère O, Mawet A, Reginster JY (2004) Primary prevention of osteoporosis: mass screening scenario or pre-screening with questionnaires? An economic perspective. J Bone Miner Res 19(12):1955-1960
Kowalski SC, Sjenzfeld VL, Ferraz MB (2004) Resource utilization in postmenopausal osteoporosis without incident fractures. J Rheumatol 31(5):938-942
Kanis JA, Delmas P, Burckhardt P, Cooper C, Torgerson D (1997) Guidelines for diagnosis and management of osteoporosis. The European Foundation for Osteoporosis and Bone Disease. Osteoporos Int 7(4):390-406
Lane A (1996) Direct costs of osteoporosis for New Zealand women. Pharmacoeconomics 9(3):231-245
Krappweis J, Rentsch A, Schwarz UI, Krobot KJ, Kirch W (1999) Outpatient costs of osteoporosis in a national health insurance population. Clin Ther 21(11):2001-2014
Ethgen O, Tellier V, Sedrine WB, De Maeseneer J, Gosset C, Reginster JY (2003) Health-related quality of life and cost of ambulatory care in osteoporosis: how may such outcome measures be valuable information to health decision makers and payers? Bone 32(6):718-724
Felts W, Yelin E (1989) The economic impact of rheumatic diseases in the United States. J Rheumatol 16(7):867-884
Ray NF, Chan JK, Thamer M, Melton LJ (1997) Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: Report from the National Osteoporosis Foundation. J Bone Miner Res 12(1):24-35
Rabenda V, Manette C, Lemmens R, Mariani AM, Struvay N, Reginster JY (2005) Prevalence and impact of osteoarthritis and osteoporosis on health-related quality of life among active subjects [Abstract]. Osteoporos Int 16[Suppl 3]:S110
Suriyawongpaisal P, Chariyalertsak S, Wanvarie S (2003) Quality of life and functional status of patients with hip fractures in Thailand. Southeast Asian J Trop Med Public Health 34(2):427-432
Cooper C (1997) The crippling consequences of fractures and their impact on quality of life. Am J Med 103[Suppl 2A]: 12S-17S
Heliövaara M, Aromaa A, Klaukka T, Knekt P, Joukamaa M, Impivaara O (1993) Reliability and validity of interview data on chronic diseases. The Mini-Finland Health Survey. J Clin Epidemiol 46(2):181-191
Studney DR, Hakstian AR (1981) A comparison of medical record with billing diagnostic information associated with ambulatory medical care. Am J Public Health 71(2):145-149
Yaffe R, Shapiro S, Fuchseberg RR, Rohde CA, Corpeno HC (1978) Medical economics survey-methods study: cost-effectiveness of alternative survey strategies. Med Care 16(8): 641-659
Goossens ME, Rutten-van Molken MP, Vlaeyen JW, van der Linden SM (2000) The cost diary: a method to measure direct and indirect costs in cost-effectiveness research. J Clin Epidemiol 53(7):688-695