Incremental Costs in Giant Cell Arteritis |
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| Authors: | Michael Mounié Nadège Costa Laurent Sailler Maryse Lapeyre‐Mestre Robert Bourrel Nicolas Savy Laurent Molinier Grégory Pugnet |
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| Institution: | 1. Centre Hospitalier Universitaire de Toulouse, UMR 1027 INSERM, and Université de Toulouse, Toulouse, France;2. Centre Hospitalier Universitaire de Toulouse, UMR 1027 INSERM, Toulouse, France;3. UMR 1027 INSERM, Université de Toulouse, and Service de Médecine Interne, CHU Toulouse, Toulouse, France;4. UMR 1027 INSERM, Université de Toulouse, Laboratoire de Pharmacologie Médicale et Clinique, Service de Pharmacologie Clinique, CIC 1436, CHU Toulouse, Toulouse, France;5. Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Service Médical Midi‐Pyrénées, Toulouse, France;6. Université de Toulouse, and Institut Mathématiques de Toulouse, UMR 5219, CNRS, Toulouse, France |
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| Abstract: | Objective To assess and compare direct costs between giant cell arteritis (GCA) patients and matched controls and to identify incremental cost drivers. Methods We carried out a population‐based, retrospective cohort study using the French National Health Insurance System database. Cost analysis was performed from the French health insurance perspective and took into account direct medical and nonmedical costs (2014, €). Costs were evaluated according to different cost components and divided into periods of 6 months for the accurate assessment of care consumption. Longitudinal multivariate regression analyses using generalized estimating equations were used to adjust the effect of GCA on the mean cost over time. Results Analyses were performed on 96 incident GCA patients and 563 matched controls. The cumulative incremental cost due to GCA was €6,406 and €7,236 for 3 and 5 years, respectively. Total incremental costs were significant for the first 18 months, amounting to €1,342 for the first 6 months, €1,498 between 6 and 12 months, and €1,165 between 12 and 18 months (P = 0.012, P = 0.065, and P = 0.029, respectively). The most important cost drivers were paramedical procedures, inpatient stays, medication, and medical procedures. Multivariate analysis shows the significant effect of GCA on mean cost during the first 3 years of followup (relative risk RR] 1.72 95% confidence interval (95% CI) 1.31–2.27], P < 0.001) with significant cost reductions (RR 0.70 95% CI 0.49–0.99], P = 0.05) at the end of followup. Conclusion This study provides an accurate assessment of GCA costs during a 5‐year period and gives useful information for future cost‐effectiveness studies based on new expensive biotherapies. |
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