Presentation (CTI)

OBJECTIVES: Ankylosing spondylitis (AS) is a severe disease resulting in chronic pain, early disability, and high treatment costs. This progressive inflammation of the spine most often affects young men of working age. Treatment of AS and its complications imposes a significant financial burden on the healthcare system. Moreover, the progressive nature of the disease severely impacts the health and professional lives of patients, leading to early disability, decreased productivity, and ultimately job loss. Objective: To assess the burden of AS from a government perspective by evaluating both direct costs (disease treatment, complications, and patient monitoring) and indirect costs (disability benefits, decreased productivity, and loss of ability to work).
METHODS: Based on real-world clinical practice data, the frequency of biologic drug prescriptions and associated costs were determined. Standards and clinical guidelines were analyzed to calculate the costs of standard therapy. Economic losses due to disability were estimated based on patient entitlements, while losses due to decreased productivity and job loss were evaluated using a human capital approach over a one-year period.
RESULTS: Total direct medical costs for treating 59,428 Russian patients with ankylosing spondylitis amounted to $61.3 million per year. The analysis revealed that biologic therapy accounted for the largest share of direct medical costs (89%). High rates of premature disability and reduced productivity resulted in annual economic losses of $362 million.
CONCLUSIONS: Delayed diagnosis (occurring on average 9 years after disease onset), coupled with late initiation of highly effective modern biological therapy (prescribed in less than 15% of indicated cases), contributes to substantial disability among patients, leading to severe economic consequences. Furthermore, patients experience a profound decrease in productivity, which often results in unemployment and additional societal losses.