Large differences in cost of illness and wellbeing between patients with fibromyalgia, chronic low back pain, or ankylosing spondylitis
Open accessAbstract
Objective To compare the cost of illness of three musculoskeletal conditions in relation to general wellbeing.Methods Patients with fibromyalgia, chronic low back pain (CLBP), and ankylosing spondylitis who were referred to a specialist and participated in three randomised trials completed a cost diary for the duration of the study, comprising direct medical and non-medical resource utilisation and inability to perform paid and unpaid work. Patients rated perceived wellbeing (0-100) at baseline. Univariate differences in costs between the groups were estimated by bootstrapping. Regression analyses assessed which variables, in addition to the condition, contributed to costs and wellbeing.Results 70 patients with fibromyalgia, 110 with chronic low back pain, and 111 with ankylosing spondylitis provided data for the cost analyses. Average annual disease related total societal costs per patient were 7813 euro for fibromyalgia, 8533 euro for CLBP, and 3205 euro for ankylosing spondylitis. Total costs were higher for fibromyalgia and CLBP than for ankylosing spondylitis, mainly because of cost of formal and informal care, aids and adaptations, and work days lost. Wellbeing was lower in fibromyalgia (mean, 48) and low back pain (mean, 42) than in ankylosing spondylitis (mean, 67). No variables other than diagnostic group contributed to differences in costs or wellbeing.Conclusions In patients under the care of a specialist, there were marked differences in costs and wellbeing between those with fibromyalgia or CLBP and those with ankylosing spondylitis. In particular, direct non-medical costs and productivity costs were higher in fibromyalgia and CLBP.
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Patients with fibromyalgia miss more days of work than colleagues without fibromyalgia.
“Patients with fibromyalgia were found to miss more days of work than their colleagues without fibromyalgia.8,9”
From Does work have to be so painful? A review of the literature examining the effects of fibromyalgia on the working experience from the patient perspective (2020) · cites this paper as [8]
The Costs section reports 34 sick-leave days per working patient-year for patients with fibromyalgia, compared with 12 for patients with ankylosing spondylitis—but 79 for patients with chronic low back pain. The paper compares these patient groups, not fibromyalgia patients with colleagues without fibromyalgia, so it does not support the claim's general comparator. (LLM, conf=0.86)
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- Authors
- Boonen, A., van den Heuvel, R., van Tubergen, A., Goossens, M., Severens, J. L., van der Heijde, D., & van der Linden, S.
- Affiliations
- Maastricht University Medical Centre (NL)
- Maastricht University (NL)
- Corresponding author
- Boonen, A
- Venue
- Annals of the Rheumatic Diseases
- Publisher
- Elsevier BV
- Published
- 2005-03
- Volume
- 64
- Issue
- 3
- Pages
- 396-402
- ISSN
- 0003-4967 (ISSN-L)
- PMC
- PMC1755408
- OpenAlex
- W2135164725
- Cited by
- 219
- References
- 25
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 6 · 2023: 7 · 2022: 13 · 2021: 10 · 2020: 11 · 2019: 4 · 2018: 3 · 2017: 11 · 2016: 18 · 2015: 11 · 2014: 9 · 2013: 12 · 2012: 18
- FWCI
- 3.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of the Rheumatic Diseases (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- HighWire Press Open Archive (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- fibromyalgia, chronic low back pain, ankylosing spondylitis, economic burden, well-being, musculoskeletal disorders, social costs, informal care, productivity loss, work disability, resource utilization (health care)
- MeSH terms
- Adult, Female, Fibromyalgia, Health Resources, Health Services Research, Humans, Male, Middle Aged, Netherlands, Quality of Life, Rheumatic Diseases, Spondylitis, Ankylosing, Proportional Hazards Models, Health Care Costs, Low Back Pain, Cost of Illness
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