Burden of Rheumatoid Arthritis: a Socioeconomic Survey (BRASS)

Published: 25 Apr 2017

The University of Chester and HCD Economics in partnership with the NRAS have embarked on a comprehensive bottom-up burden of illness study to provide the community with per-patient societal costs; direct medical, direct non-medical and indirect costs.

BRASS banner

Ten countries participated in the study during Q2-16 (except France in Q1-17); Denmark, France, Germany, Hungary, Italy, Poland, Romania, Spain, Sweden and the UK.

Robust independent data on the ‘real life’ burden and true costs of rheumatoid arthritis is needed to quantify the wider impact of both treatments and treat to target strategy. Current market access methodology almost exclusively focuses on direct costs. This undoubtedly underestimates the true cost effectiveness of clinically effective treatments. HTA processes are becoming more sophisticated, aiming to ensure that a full analysis of societal costs and benefits feature in the decision-making process. Greater access to quantitative evidence detailing the wider impact is needed. The BRASS study provides this evidence, with demographic, clinical, 12-month ambulatory and secondary care activity collected on 4,200 patients plus corresponding 2,087 patients self-reporting direct and indirect non-medical cost and quality of life information.

NRAS CEO, Alisa Bosworth, stated:

One of the frustrations that we have had is not having access to up to date, accurate data about the costs associated with living with this disease, which is why we were delighted when the University of Chester and HCD approached us with a proposal to do a pan-European study on the economic burden of RA.

Of particular interest was the data, which this study would provide on the wider societal costs including the cost of lost productivity. If we are to be able to truly optimise medicines in the future, the real costs both to the individual and their family as well as wider society, including lost productivity must be factored into their use. It makes no sense for bodies such as NICE to continue to ignore the true cost of treating people with complex conditions such as RA.”

Key findings from BRASS show indirect costs; short, medium, and long term sick leave (including early retirement) having an annual per-patient cost greater than either direct medical (excluding drug costs) or direct non-medical costs. Along with financial implications, the human burden must also be measured.

Decision makers are aware that resource implications need to be considered in a world of finite resources. BRASS lays bare the wider societal impact of living with RA and the challenges facing national health services. To really address patient care and optimise outcomes, direct and indirect costs must be accepted as a combined unit.

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