Large differences in cost-of-illness and well being between patients with
fibromyalgia, chronic low back pain or ankylosing spondylitis.

Ann Rheum Dis. 2004 Jul 22 

Boonen A, Van Den Heuvel R, Van Tubergen A, Goossens M, Severens J, Van Der
Heijde D, Van Der Linden S.

University Hospital Maastricht, The Netherlands.

PMID: 15271773


OBJECTIVE: To compare the cost-of-illness of three musculoskeletal
conditions in relation to general well-being.

METHODS: Patients with fibromyalgia, chronic low back pain and ankylosing
spondylitis who were referred to a specialist and participated in three
randomised trials, completed for the duration of the study a cost- diary
comprising direct medical and non-medical resource utilisation and
inability to perform paid and unpaid work. At baseline, patients rated
perceived well-being (0-100). Univariate differences in costs between the
groups were estimated by bootstrapping. Regression analyses assessed which
variables, in addition to the condition contributed to costs.

RESULTS: 70 patients with fibromyalgia, 110 patients with chronic low back
pain and 111 patients with ankylosing spondylitis provided data for the
cost- analyses. The average annual disease related total societal costs
were Euro7,813, Euro8,533 and Euro3,205 per patient in fibromyalgia,
chronic low back pain and ankylosing spondylitis respectively. Total costs
were higher in fibromyalgia and low back pain compared with ankylosing
spondylitis mainly because of costs for formal and informal care, aids and
adaptations and workdays lost. Well being was lower in fibromyalgia (mean:
48) and low back pain (mean: 42) compared with ankylosing spondylitis
(mean: 67). No variables other than diagnostic group contributed to
differences in costs or well being.

CONCLUSION: Remarkable differences in costs and well-being were noticed
between patients with fibromyalgia and chronic low back pain under care of
a specialist on the one hand and ankylosing spondylitis on the other hand.
In particular, direct non-medical costs and productivity costs were higher
in fibromyalgia and chronic low back pain.