Introduction Timely diagnosis of axial spondyloarthritis (axSpA) remains challenging and delays result in harmful consequences. Few studies have evaluated the cost of delayed axSpA diagnosis. This study aims to develop an economic analysis to determine the annual cost of delaying the axSpA diagnosis, adopting both NHS (UK) and societal perspectives. Methods We developed a Markov economic model to estimate the costs of delayed axSpA diagnosis in the UK. The cohort of patients assessed comprised a mixed population (cohort size: 1,000 patients, 64% males), mean age of symptom onset 26 years. The model captured the resources used and costs related to diagnosing and managing axSpA symptoms until the disease was diagnosed. Results Results are summarised in Table 1. Our economic analysis results show the cost of delayed axSpA diagnosis is substantial and falls mainly on the individuals concerned in the form of productivity losses, out of pocket medical expenses, non-prescribed drug expenses, and travel costs to healthcare services. These costs are higher in younger patients but remain substantial in older groups. With a symptom onset at the age of 26 and an average time to diagnosis of 8.5 years, we estimate that the cumulative cost of delayed diagnosis per person living with axial SpA is £193,512 (CI95%: £108,769 - £306,789). The total annual cost that accrues to delay before the diagnosis of axSpA in the UK was £3.1 billion and £12.4 billion, based on a prevalence of 0.3% and 1.2%, respectively (Table 1). Our results corroborate findings from other studies, showing that patients with a late diagnosis of axSpA had higher costs, reduced incapacity for work, and worse clinical outcomes1,2. P005 Table 1.Nationwide total cost of delaying the axSpA diagnosis based on axSpA prevalence.Prevalence of 0.3%Prevalence of 1.2%ResultsTotal cost - ModelledTotal cost – NASS pop*Total cost – UK adult pop**Total cost – UK adult pop**DSA£23,104.17£4,236,794,775£3,115,805,703£12,463,222,813PSA£24,025.06£4,431,645,007£3,259,101,637£13,036,406,54995% LCI£14,568.52£2,703,455,437£1,988,163,769£7,952,655,07995% UCI£36,950.02£6,595,614,347£4,850,518,822£19,402,075,288Note: 83.4% remaining undiagnosed per year*NASS estimate population: 220,000 patients.**UK adult population (2022): 53,930,490.DSA: deterministic sensitivity analysis, LCI: low confidence interval, pop: population, PSA: probabilistic sensitivity analysis: UCI: upper confidence interval. Conclusion To our knowledge, this is the first UK-specific study and the first internationally to develop an economic analysis to determine the annual cost of delay in diagnosing axSpA, adopting both NHS and societal perspectives. Earlier diagnosis is essential in order to reduce healthcare needs, resource utilisation, and enhance the quality of life for people living with axSpA References 1. Kobelt G, et al. Value Health. 2008 May;11(3):408–15. 2. Grigg SE, et al. ACRARHP Sci Meet 2011. 2011;63(abstract 1308).

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P005 英国中轴型脊柱关节炎延迟诊断的经济负担


简介 及时诊断中轴型脊柱关节炎 （axSpA） 仍然具有挑战性，延误会导致有害后果。很少有研究评估延迟 axSpA 诊断的成本。本研究旨在开发一项经济分析，以确定延迟 axSpA 诊断的年度成本，同时采用 NHS（英国）和社会观点。方法 我们开发了一个马尔可夫经济模型来估计英国延迟 axSpA 诊断的成本。评估的患者队列由混合人群组成 （队列规模：1,000 名患者，64% 为男性），平均症状发作年龄为 26 岁。该模型捕获了在诊断出疾病之前与诊断和管理 axSpA 症状相关的使用资源和成本。结果 结果总结于表 1 中。我们的经济分析结果表明，延迟 axSpA 诊断的成本很高，主要以生产力损失、自付费用医疗费用、非处方药费用和医疗保健服务的差旅费用的形式落在相关个人身上。这些成本在年轻患者中较高，但在老年群体中仍然很高。症状在 26 岁时出现，平均诊断时间为 8.5 年，我们估计每个中轴型 SpA 患者延迟诊断的累积成本为 193,512 英镑（CI95%：108,769 英镑 - 306,789 英镑）。根据 0.3% 和 1.2% 的患病率，英国 axSpA 诊断前因延误而产生的年度总成本分别为 31 亿英镑和 124 亿英镑（表 1）。我们的结果证实了其他研究的结果，表明晚期诊断为 axSpA 的患者成本更高，工作能力减少，临床结果更差 1,2。P005 表 1.基于 axSpA 患病率延迟 axSpA 诊断的全国总成本。患病率为 0.3%患病率为 1.2%结果总成本 - 建模总成本 - NASS 流行音乐*总成本 - 英国成人流行音乐**总成本 - 英国成人流行音乐**DSA£23,104。 17£4,236,794,775£3,115,805,703£12,463,222,813PSA£24,025.06£4,431,645,007£3,259,101,637£13,036,406,54995 LCI£14,568.52£2,703,455,437£1,988,163,769£7,952,655,07995% UCI£36,950,614,347£4,850,518,822£4,850,518,822£19,402,075,288注意：每年有83.4%的人未确诊*NASS估计人口：220,000名患者。**英国成年人口（2022年）： 53,930,490.DSA： 确定性敏感性分析， LCI： 低置信区间， pop： 总体， PSA： 概率敏感性分析： UCI： 置信区间上限。结论据我们所知，这是第一项针对英国的研究，也是第一项国际上开发经济分析以确定延迟诊断 axSpA 的年度成本的研究，采用 NHS 和社会观点。为了减少医疗保健需求、资源利用率和提高 axSpA 患者的生活质量，早期诊断是必不可少的 参考文献 1.Kobelt G 等人，价值健康。2008 年 5 月;11(3):408–15.2. Grigg SE 等人，ACRARHP Sci Meet 2011。2011;63（摘要 1308）。