Dr Georgios Xydopoulos, Dr Stephanie Howard Wilsher, Dr Fernando Zanghelini, Oyewumi Afolabi (Norwich Medical School)

Axial Spondyloarthritis (Axial SpA) is an umbrella term for a form of inflammatory arthritis that affects the spine and sacroiliac joints. Axial Spa is characterised by inflammatory pain and functional impairment and can have a devastating impact on the lives of those living with it. Onset of Axial SpA typically starts between late teen years to early twenties, with an average age of symptom onset of 26. Hence, this condition can have a life-long impact and long-term complications if left untreated. Diagnosis is difficult and often delayed several years after the appearance of symptoms – on average patients wait 8.5 years for a diagnosis from the moment of symptom onset.

Previous studies have focussed mainly on costs associated with the diagnosis of axial SpA and the treatment costs. However, the costs incurred prior to diagnosis and in particular costs borne by the patients or their caregivers, such as transportation and over-the-counter medications, or the productivity losses arising from work absence, inability to work or early mortality, have received little attention to date. Given the average delay from the onset of symptoms to the diagnosis is around 8.5 years, considerable costs incur, both at societal and individual level and these are larger over longer delay periods.

Health Economics Consulting (HEC) in collaboration with National Axial Spondyloarthritis Society (NASS) analysed data from 2,827 anonymised patient records over the last 10-15 years developing a health economics model in accordance to NICE standards that adopts a broad societal perspective for estimating the burden of delayed diagnosis, up to the point of diagnosis for those living with axial SpA in the UK, including out of pocket expenses, medical costs, productivity losses and broader social costs.