AB1237\u2005COST OF ILLNESS AND QUALITY OF LIFE IN ANKYLOSING SPONDYLITIS PATIENTS TREATED WITH ADALIMUMAB IN CHINA

Abstract

Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease which may lead to limited physical function, impaired quality of life and increased economic burden for society. There were many studies about the superior effects of biologic agents on symptom release, disease activity and functional remission in AS patients. However, studies on the economic burden and health-related quality of life of AS patients in China were spark. Objectives: To access the cost of illness, work limitation and quality of life in active ankylosing spondylitis (AS) patients using adalimumab in China. Methods: A prospective study was performed in 91 patients with active AS in China. Adult patients (aged ≥ 18 years) fulfilled the 1984 New York modified criteria of AS with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥ 4 and C reactive protein (CRP) 6 were enrolled from rheumatology center from Jan 2017 to Aug 2017. All participants received adalimumab (40mg per 2 weeks) therapy and completed questionnaires about disease characteristics, quality of life, direct and indirect costs. Only patients with pay-work completed the Work Limitation Questionnaire (WLQ) to accesses the impact of chronic health conditions on job performance and productivity. Quality of life was measured using the Ankylosing Spondylitis Quality of life (ASQoL) and EuroQol-5 Dimensions (EQ-5D). Results: A total of 91 patients with mean age of 30 years old (87.8% males) and mean disease duration of 10 years received adalimumab treatment for 24 weeks. 78.02% of patients have a paid job with average work productivity loss of 28% measured by WLQ. The annual estimated costs of each patient were $35238.8 while the direct cost accounted for 90.2% and the cost of medication accounted for 78.6%. There were significant differences in change of ASQoL (change, 3.89 [95%CI, 3.06 to 4.71]; P<0.0001) and EQ-5D (change, -0.19 [95%CI, -0.24 to -0.31]; P<0.0001) scores from baseline and 24 weeks, with more improvements after therapy compared with baseline. Cost of illness was estimated as $21927.38 per quality-adjusted life year and $15728.16 per BASDAI unit, respectively. Conclusion: The cost of AS patients treated with adalimumab therapy was high in China and symptoms and QoL improved significantly after therapy. Disclosure of Interests: None declared