Socioeconomic aspects of ankylosing spondylitis
Mainly as a result of the high costs for Mainly as a result of the high costs for (TNF) blockers the analysis of socioeconomic data for ankylosing spondylitis, as for other chronic diseases, has become of great interest. In these kinds of analyses direct and indirect costs caused by the disease are balanced against treatment costs, savings of direct and indirect costs, and gain in quality of life. Quality of life has been found to be equally reduced in patients with ankylosing spondylitis and in patients with rheumatoid arthritis, but healthcare costs were higher in rheumatoid arthritis . An effort has been made to calculate the cost–effectiveness of the TNF–blocking agents infliximab and etanercept in the treatment of ankylosing spondylitis [102, 103]. Such a treatment seems to be cost–effective when the reduction of direct and indirect costs and the gain in quality of life are calculated against the drug costs, especially in patients with high disease activity and good response to treatment. However, future research is necessary to learn more about the natural course of the disease, prognostic factors and long–term effects of the treatment with TNF–blocking agents.