Cost-Effectiveness of Interventions for AS

Although the direct costs associated with ankylosing spondylitis are relatively low, its impact on indirect costs, including pain and suffering, are substantial. To date, little work has been done on the economics of interventions for ankylosing spondylitis. Pharmaceutical interventions are currently typically limited to NSAIDs and DMARDs such as methotrexate and sulfasalazine.
Van Tubergen and others (2002), however, analyze the cost-effectiveness of a spa exercise intervention. The intervention period was three weeks, and although the authors argue that the cost-effectiveness of the intervention was favorable, they also note that the ICERs were sensitive to variations in assumptions about indirect costs.
Although a spa exercise program is apparently beneficial and may even be considered cost-effective for ankylosing spondylitis sufferers in developed countries, the current cost-effectiveness evidence does not provide a compelling case for widespread adoption of the intervention in developing regions. Patients, however, should be encouraged to exercise, especially to swim. The cost-effectiveness of tumor necrosis factor inhibiting drugs is not yet evident for ankylosing spondylitis, but the drugs are currently unattractive investments for developing countries because of their high price.

References:

A. van Tubergen, A. Boonen, R. Landewe, M. Rutten-van Molken, D. van der Heijde, A. Hidding, and S. van der Linden. 2002. Cost Effectiveness of Combined Spa-Exercise Therapy in Ankylosing Spondylitis: A Randomized Controlled Trial Arthritis and Rheumatism 47: 5 459-67.