{
    "abstract": "To develop an economic model to determine the annual cost of delayed axial spondyloarthritis (axial SpA) diagnosis in the UK, adopting both National Health Service (NHS) and societal perspectives.\nWe developed a Markov economic model to estimate the costs of delayed axial SpA diagnosis in the UK. Model parameters were sourced from a 2016 National Axial Spondyloarthritis Society patient survey, anonymised patient level data, published literature and expert opinion. A literature defined, mixed cohort (64% male) of people assumed to have axial SpA, whose age of symptom onset was 26 years, were targeted. To assess the robustness of the results, base case and probabilistic sensitivity analyses were performed.\nIn a simulated cohort of 1,000 patients, with a mean time to diagnosis of 8.5 years, we estimate the cumulative costs of delayed diagnosis per person living with axial SpA to be \u00a3193,512 (95% CI: 108,770-306,789). The costs were led by productivity losses (65.1%) and out-of-pocket expenses (31.3%) The total annual cost resulting from delayed axial SpA diagnosis in the UK has been estimated at \u00a33.1 billion and \u00a312.5 billion, based on a prevalence of 0.3% (Assessment of SpondyloArthritis international Society classification criteria) and 1.2% (European Spondyloarthropathy Study Group classification criteria), respectively.\nDelayed axial SpA diagnosis carries high costs for society due to productivity losses. Early diagnosis and treatment could offer significant benefits to the patient and potentially reduce productivity losses; however, future research is needed to evaluate the long-term health economic impact.",
    "authors": [
        {
            "affiliation": "Health Economics Consulting, Norwich Medical School, University of East Anglia, Norwich, UK.",
            "firstname": "Fernando",
            "initials": "F",
            "lastname": "Zanghelini"
        },
        {
            "affiliation": "Health Economics Consulting, Norwich Medical School, University of East Anglia, Norwich, UK.",
            "firstname": "George",
            "initials": "G",
            "lastname": "Xydopoulos"
        },
        {
            "affiliation": "Health Economics Consulting, Norwich Medical School, University of East Anglia, Norwich, UK.",
            "firstname": "Stephanie Howard",
            "initials": "SH",
            "lastname": "Wilsher"
        },
        {
            "affiliation": "Health Economics Consulting, Norwich Medical School, University of East Anglia, Norwich, UK.",
            "firstname": "Oyewumi",
            "initials": "O",
            "lastname": "Afolabi"
        },
        {
            "affiliation": "National Axial Spondyloarthritis Society (NASS), London, UK.",
            "firstname": "Dale",
            "initials": "D",
            "lastname": "Webb"
        },
        {
            "affiliation": "National Axial Spondyloarthritis Society (NASS), London, UK.",
            "firstname": "Joe",
            "initials": "J",
            "lastname": "Eddison"
        },
        {
            "affiliation": "National Axial Spondyloarthritis Society (NASS), London, UK.",
            "firstname": "Thomas A",
            "initials": "TA",
            "lastname": "Ingram"
        },
        {
            "affiliation": "National Axial Spondyloarthritis Society (NASS), London, UK.",
            "firstname": "Clare",
            "initials": "C",
            "lastname": "Clark"
        },
        {
            "affiliation": "National Axial Spondyloarthritis Society (NASS), London, UK.",
            "firstname": "Jill",
            "initials": "J",
            "lastname": "Hamilton"
        },
        {
            "affiliation": "Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK.",
            "firstname": "Raj",
            "initials": "R",
            "lastname": "Sengupta"
        },
        {
            "affiliation": "Rheumatology, Norfolk & Norwich University Hospitals NHS Foundation Trust, Norwich, UK.",
            "firstname": "Karl",
            "initials": "K",
            "lastname": "Gaffney"
        },
        {
            "affiliation": "Health Economics Consulting, Norwich Medical School, University of East Anglia, Norwich, UK.",
            "firstname": "Richard",
            "initials": "R",
            "lastname": "Fordham"
        }
    ],
    "conclusions": "Delayed axial SpA diagnosis carries high costs for society due to productivity losses. Early diagnosis and treatment could offer significant benefits to the patient and potentially reduce productivity losses; however, future research is needed to evaluate the long-term health economic impact.",
    "copyrights": "\u00a9 The Author(s) 2025. Published by Oxford University Press on behalf of the British Society for Rheumatology.",
    "doi": "10.1093/rheumatology/keaf226",
    "journal": "Rheumatology (Oxford, England)",
    "keywords": [
        "Axial spondyloarthritis",
        "ankylosing spondylitis",
        "burden",
        "cost",
        "delayed diagnosis",
        "economic evaluation"
    ],
    "methods": null,
    "publication_date": "2025-04-25",
    "pubmed_id": "40279291",
    "results": "In a simulated cohort of 1,000 patients, with a mean time to diagnosis of 8.5 years, we estimate the cumulative costs of delayed diagnosis per person living with axial SpA to be \u00a3193,512 (95% CI: 108,770-306,789). The costs were led by productivity losses (65.1%) and out-of-pocket expenses (31.3%) The total annual cost resulting from delayed axial SpA diagnosis in the UK has been estimated at \u00a33.1 billion and \u00a312.5 billion, based on a prevalence of 0.3% (Assessment of SpondyloArthritis international Society classification criteria) and 1.2% (European Spondyloarthropathy Study Group classification criteria), respectively.",
    "title": "What is the economic burden of delayed axial spondyloarthritis diagnosis in the UK?",
    "xml": "<Element 'PubmedArticle' at 0x788506caaf70>"
}