IDEAS home Printed from https://ideas.repec.org/a/spr/eujhec/v15y2014i1p83-92.html
   My bibliography  Save this article

Subjective health expectations at biological therapy initiation: a survey of rheumatoid arthritis patients and rheumatologists

Author

Listed:
  • Márta Péntek
  • László Gulácsi
  • Bernadette Rojkovich
  • Valentin Brodszky
  • Job Exel
  • Werner Brouwer

Abstract

Subjective health expectations of patients with rheumatoid arthritis (RA) and rheumatologists remain understudied. We measured subjective expectations regarding treatment effects of biologicals as well as future length and quality of life. Moreover, we compared expectations regarding treatment effects to actual treatment effects. We recruited a sample of Hungarian RA patients initiating treatment with biologicals. Expectations regarding treatment effects and future health were obtained through a written questionnaire from patients and physicians, including functional impairment (HAQ-DI), health status (EQ-5D) and disease activity (DAS28). After three months, actual treatment effects were obtained. Ninety-two RA patients (females N = 81, 88 %) with mean age of 51 (SD 12) and disease duration of 9 (SD 8) years with high average disease activity (DAS28: 6.1) were included. Patients expected significant and large health improvement within three months with mean changes on the HAQ-DI of −0.8 and on the EQ-5D of +0.4. Rheumatologists’ estimates were similar, and they expected significant decrease of 2.3 on the DAS28. Actual scores after three months were obtained for 77 patients. The measured scores were significantly lower than expected scores for the HAQ-DI and EQ-5D. Rheumatologists’ expectations for the DAS28 score were not significantly different from measured scores. Patients’ average expectations regarding quality of life scores for ages 60, 70, 80 and 90 were 0.44, 0.24, 0.06 and −0.02, respectively. Our results suggest that both RA patients and rheumatologists expect quick and significant health improvements from biological drugs and tend to overestimate actual short term treatment effects. Nonetheless, RA patients expect a sharp deterioration of future health. Copyright Springer-Verlag Berlin Heidelberg 2014

Suggested Citation

  • Márta Péntek & László Gulácsi & Bernadette Rojkovich & Valentin Brodszky & Job Exel & Werner Brouwer, 2014. "Subjective health expectations at biological therapy initiation: a survey of rheumatoid arthritis patients and rheumatologists," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(1), pages 83-92, May.
    • Handle: RePEc:spr:eujhec:v:15:y:2014:i:1:p:83-92
    DOI: 10.1007/s10198-014-0597-1
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1007/s10198-014-0597-1
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1007/s10198-014-0597-1?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Brouwer, Werner B.F. & van Exel, N. Job A., 2005. "Expectations regarding length and health related quality of life: Some empirical findings," Social Science & Medicine, Elsevier, vol. 61(5), pages 1083-1094, September.
    2. B. Jönsson & G. Kobelt & J. Smolen, 2008. "The burden of rheumatoid arthritis and access to treatment: uptake of new therapies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(2), pages 61-86, January.
    3. J. Lundkvist & F. Kastäng & G. Kobelt, 2008. "The burden of rheumatoid arthritis and access to treatment: health burden and costs," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(2), pages 49-60, January.
    4. Mirowsky, John, 1999. "Subjective life expectancy in the US: correspondence to actuarial estimates by age, sex and race," Social Science & Medicine, Elsevier, vol. 49(7), pages 967-979, October.
    5. Marra, Carlo A. & Woolcott, John C. & Kopec, Jacek A. & Shojania, Kamran & Offer, Robert & Brazier, John E. & Esdaile, John M. & Anis, Aslam H., 2005. "A comparison of generic, indirect utility measures (the HUI2, HUI3, SF-6D, and the EQ-5D) and disease-specific instruments (the RAQoL and the HAQ) in rheumatoid arthritis," Social Science & Medicine, Elsevier, vol. 60(7), pages 1571-1582, April.
    6. J. Lundqvist & F. Kastäng & G. Kobelt & B. Jönsson, 2008. "The burden of rheumatoid arthritis and access to treatment: determinants of access," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(2), pages 87-93, January.
    7. G. Kobelt & B. Jönsson, 2008. "The burden of rheumatoid arthritis and access to treatment: outcome and cost-utility of treatments," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(2), pages 95-106, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Márta Péntek & Ottó Hajdu & Fanni Rencz & Zsuzsanna Beretzky & Valentin Brodszky & Petra Baji & Zsombor Zrubka & Klára Major & László Gulácsi, 2019. "Subjective expectations regarding ageing: a cross-sectional online population survey in Hungary," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 17-30, June.
    2. Márta Péntek & Bernadette Rojkovich & László Czirják & Pál Géher & Péter Keszthelyi & Attila Kovács & László Kovács & Zita Szabó & Zoltán Szekanecz & László Tamási & Ágnes Tóth & Ilona Ujfalussy & Noé, 2014. "Acceptability of less than perfect health states in rheumatoid arthritis: the patients’ perspective," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(1), pages 73-82, May.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Azucena Pedraz-Marcos & Ana María Palmar-Santos & Claire Anne Hale & Juan Zarco-Colón & Milagros Ramasco-Gutiérrez & Eva García-Perea & Teresa Velasco-Ripoll & Josefina Martín-Alarcón & Nuria Sa, 2020. "Living With Rheumatoid Arthritis in Spain: A Qualitative Study of Patient Experience and the Role of Health Professionals," Clinical Nursing Research, , vol. 29(8), pages 551-560, November.
    2. Karine Chevreul & Georges Haour & Sandy Lucier & Stephanie Harvard & Marie-Laure Laroche & Xavier Mariette & Alain Saraux & Isabelle Durand-Zaleski & Francis Guillemin & Bruno Fautrel, 2014. "Evolution of Direct Costs in the First Years of Rheumatoid Arthritis: Impact of Early versus Late Biologic Initiation - An Economic Analysis Based on the ESPOIR Cohort," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-9, May.
    3. Kurt Brekke & Dag Dalen & Tor Holmås, 2014. "Diffusion of pharmaceuticals: cross-country evidence of anti-TNF drugs," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(9), pages 937-951, December.
    4. Evo Alemao & Maiwenn J Al & Annelies A Boonen & Matthew D Stevenson & Suzanne M M Verstappen & Kaleb Michaud & Michael E Weinblatt & Maureen P M H Rutten-van Mölken, 2018. "Conceptual model for the health technology assessment of current and novel interventions in rheumatoid arthritis," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-18, October.
    5. Márta Péntek & Gyula Poór & Piotr Wiland & Martina Olejárová & Marek Brzosko & Catalin Codreanu & Nóra Brodszky & László Gulácsi, 2014. "Biological therapy in inflammatory rheumatic diseases: issues in Central and Eastern European countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(1), pages 35-43, May.
    6. Ulf Persson, 2012. "Value Based Pricing in Sweden: Lessons for Design?," Seminar Briefing 000141, Office of Health Economics.
    7. Benjamin Birkner & Jürgen Rech & Tom Stargardt, 2020. "Cost-utility analysis of de-escalating biological disease-modifying anti-rheumatic drugs in patients with rheumatoid arthritis," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-17, January.
    8. László Gulácsi, 2010. "Future challenges for health economics and health technology assessment of biological drugs," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(3), pages 235-238, June.
    9. Bogdan Batko & Paulina Rolska-Wójcik & Magdalena Władysiuk, 2019. "Indirect Costs of Rheumatoid Arthritis Depending on Type of Treatment—A Systematic Literature Review," IJERPH, MDPI, vol. 16(16), pages 1-16, August.
    10. Paul Gavaza & Karen Rascati & Abiola Oladapo & Star Khoza, 2012. "The State of Health Economic Research in South Africa," PharmacoEconomics, Springer, vol. 30(10), pages 925-940, October.
    11. Sonja Merkesdal & Timm Kirchhoff & Diane Wolka & Gunter Ladinek & Adrian Kielhorn & Andrea Rubbert-Roth, 2010. "Cost-effectiveness analysis of rituximab treatment in patients in Germany with rheumatoid arthritis after etanercept-failure," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(1), pages 95-104, February.
    12. Bruno Arpino & Pierluigi Conzo & Francesco Salustri, 2022. "I am a survivor, keep on surviving: early-life exposure to conflict and subjective survival probabilities in adult life," Journal of Population Economics, Springer;European Society for Population Economics, vol. 35(2), pages 471-517, April.
    13. Michael Drummond & Bengt Jönsson & Frans Rutten & Tom Stargardt, 2011. "Reimbursement of pharmaceuticals: reference pricing versus health technology assessment," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(3), pages 263-271, June.
    14. Patrick Meyer & Gregory Ponthiere, 2020. "Human lifetime entropy in a historical perspective (1750–2014)," Cliometrica, Journal of Historical Economics and Econometric History, Association Française de Cliométrie (AFC), vol. 14(1), pages 129-167, January.
    15. Brigitte Dormont & Anne-Laure Samson & Marc Fleurbaey & Stéphane Luchini & Erik Schokkaert, 2018. "Individual Uncertainty About Longevity," Demography, Springer;Population Association of America (PAA), vol. 55(5), pages 1829-1854, October.
    16. P. Laires & F. Exposto & R. Mesquita & A. Martins & L. Cunha-Miranda & J. Fonseca, 2013. "Patients’ access to biologics in rheumatoid arthritis: a comparison between Portugal and other European countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(6), pages 875-885, December.
    17. Jaana T Joensuu & Saara Huoponen & Kalle J Aaltonen & Yrjö T Konttinen & Dan Nordström & Marja Blom, 2015. "The Cost-Effectiveness of Biologics for the Treatment of Rheumatoid Arthritis: A Systematic Review," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-27, March.
    18. Nick Bansback & Huiying Sun & Daphne P. Guh & Xin Li & Bohdan Nosyk & Susan Griffin & Paul G. Barnett & Aslam H. Anis, 2008. "Impact of the recall period on measuring health utilities for acute events," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1413-1419.
    19. Joan Costa-Font & Cristina Vilaplana-Prieto, 2022. "Biased survival expectations and behaviours: Does domain specific information matter?," Journal of Risk and Uncertainty, Springer, vol. 65(3), pages 285-317, December.
    20. Brazier, JE & Yang, Y & Tsuchiya, A, 2008. "A review of studies mapping (or cross walking) from non-preference based measures of health to generic preference-based measures," MPRA Paper 29808, University Library of Munich, Germany.

    More about this item

    Keywords

    Arthritis; rheumatoid; Biological drugs; Health expectations; EQ-5D; Hungary; I19;
    All these keywords.

    JEL classification:

    • I19 - Health, Education, and Welfare - - Health - - - Other

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:eujhec:v:15:y:2014:i:1:p:83-92. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.