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VBCR - August 2014, Volume 3, No 4 - Health Economics
Phoebe Starr

Paris, France—Musculoskeletal conditions (MSKCs), which consist of approximately 150 different diseases, are the main driver of healthcare costs, according to a Dutch study presented at the 2014 European League Against Rheumatism (EULAR) Congress. MSKCs were the single most costly of any chronic health condition (direct and indirect costs), including migraine, cancer, respiratory, skin, mental, and bowel conditions. The presence of MSKCs led to the steepest increase in costs in patients with additional comorbidities.

Data Applicable in United States
Even though this was a Dutch study, these data are generalizable to other Western countries, including the United States, according to Gerd Burmester, MD, President of EULAR, and Professor of Medicine, Department of Rheumatology and Clinical Immunology at the Charité University Hospital, Free University and Humboldt University of Berlin, Germany.

This was further validated by the lead author of the study, Antje van der Zee-Neuen, MD, Maastricht University, the Netherlands, who agreed that the study results are applicable to Europe and the United States.

“It is clear that the cost of delivering care to patients with musculoskeletal conditions is considerably higher than for those with other diseases. The implication of our study is that policymakers should pay attention to these findings by prioritizing MSKCs in their healthcare budgets,” she stated.

Awareness Needed Among Physicians, Policymakers
The results of this study were based on a cross-sectional household survey of 8904 randomly selected Dutch individuals 18 years old and older who completed a questionnaire on sociodemographic and lifestyle factors; self-reported, physician-diagnosed diseases; and self-reported healthcare costs over the last 3 months.

Twenty-nine percent of the study population reported 1 morbidity; 8.5% had an MSKC condition as a single condition. More than 1 disease was reported in 19% of respondents, and MSKC was 1 of those comorbidities in 20%. MSKC was reported in 6.1% of individuals with 2 comorbidities, and 5.6% with >2 comorbidities. Each additional morbidity led to a steep increase in costs; costs were highest when MSKC was present.

“Costs for an individual with 2 conditions—neither of which was MSKC—were twice as high as costs for a healthy person,” Dr van der Zee-Neuen explained. “But if one of the individual’s 2 diseases was musculoskeletal, healthcare costs were 3 times higher.”

Reference prices from the Dutch manual for pharmacoeconomic healthcare evaluations 2010, which were adjusted for inflation, were used to estimate total healthcare costs for 3 months per individual with and without MSKC as a single condition and for an individual with comorbidities with and without MSKC.

The average healthcare cost for a healthy individual for 3 months was estimated at approximately $233, $444 for men with MSKC as a single morbidity and $654 for women. The addition of MSKC to 2 comorbidities increased 3-month costs by about $250 compared with those same comorbidities without MSKC.

Dr van der Zee-Neuen said she hopes this study raises the awareness of physicians and policymakers about the high costs of treating patients with MSKCs, and that it generates cross-talk among rheumatologists, family physicians, and other specialists who treat patients with these diseases to provide optimal treatments and reduce associated costs.

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