Cost analysis of work and household productivity improvements with certolizumab pegol in patients with non-radiographic axial spondyloarthritis in spain

To calculate the economic impact on work productivity (WP) and household productivity (HHP) in patients with non-radiographic axial spondyloarthritis (nr-axSpA) treated with certolizumab pegol (CZP) plus non-biologic background medication (NBBM) versus NBBM applied to the Spanish healthcare system. A cost-analysis model to calculate WP (indirect) and HHP (non-healthcare direct)-related costs was performed. Productivity data were obtained from a clinical trial comparing CZP plus NBBM versus NBBM over 52 weeks in 317 patients. WP and HHP were evaluated in number of days lost per month and days per month with reduced productivity ≥50%, due to nr-axSpA. The cost of a lost workday (WP) (€86.44/day; €2019) was obtained from the Spanish National Institute of Statistics considering labour costs. The cost of HHP assuming that, if activities at home could not be carried out by the patient, a caregiver or external staff would be required with a cost per day equal to the minimum inter-professional salary (€31.21/day; €2019). Monthly costs derived from WP loss per treated patient with CZP/NBBM and NBBM were €159.91 and €419.22, respectively. CZP treatment would provide benefits, in terms of WP loss avoided of €259.31/month and €3,111.70/year. HHP loss in patients treated with CZP/NBBM would imply €137.33 versus €248.13 with NBBM per month, generating benefits of €110.80/month and €1,329.61/year in CZP/NBBM treated patients. Aggregately treatment with CZP/NBBM versus NBBM reflects an average annual benefit of €4,441.31/patient. There is a lack of information on how biologic therapies have impact on the economic burden, from the societal perspective, due to productivity benefits. The results of this analysis suggest that treatment of nr-axSpA with CZP/NBBM versus NBBM could generate benefits for society by increasing WP, and for patient in terms of HHP in Spanish setting.