What is the economic burden of delayed axial spondyloarthritis diagnosis in the UK?

Fernando Zanghelini, George Xydopoulos, Stephanie howard Wilsher, Oyewumi Afolabi, Dale Webb, Joe Eddison, Thomas A. Ingram, Clare Clark, Jill Hamilton, Raj Sengupta, Karl Gaffney, Richard Fordham

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Abstract

Objectives: To develop an economic model to determine the annual cost of delayed axial spondyloarthritis (axial SpA) diagnosis in the UK, adopting both National Health Service (NHS) and societal perspectives.

Methods: We developed a Markov economic model to estimate the costs of delayed axial SpA diagnosis in the UK. Model parameters were sourced from a 2016 National Axial Spondyloarthritis Society patient survey, anonymised patient level data, published literature and expert opinion. A literature defined, mixed cohort (64% male) of people assumed to have axial SpA, whose age of symptom onset was 26 years, were targeted. To assess the robustness of the results, base case and probabilistic sensitivity analyses were performed.

Results: In a simulated cohort of 1,000 patients, with a mean time to diagnosis of 8.5 years, we estimate the cumulative costs of delayed diagnosis per person living with axial SpA to be £193,512 (95% CI: 108,770—306,789). The costs were led by productivity losses (65.1%) and out-of-pocket expenses (31.3%) The total annual cost resulting from delayed axial SpA diagnosis in the UK has been estimated at £3.1 billion and £12.5 billion, based on a prevalence of 0.3% (Assessment of SpondyloArthritis international Society classification criteria) and 1.2% (European Spondyloarthropathy Study Group classification criteria), respectively.

Conclusion: Delayed axial SpA diagnosis carries high costs for society due to productivity losses. Early diagnosis and treatment could offer significant benefits to the patient and potentially reduce productivity losses; however, future research is needed to evaluate the long-term health economic impact.
Original languageEnglish
Article numberkeaf226
JournalRheumatology
Early online date25 Apr 2025
DOIs
Publication statusE-pub ahead of print - 25 Apr 2025

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