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Clin Exp Rheumatol. 2010 Jul-Aug;28(4):490-7. Epub 2010 Aug 30.

Resource utilisation and cost of ankylosing spondylitis in Brazil.

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Department of Medicine, Division of Rheumatology, Universidade Federal de São Paulo, Brazil.



The present study describes resource utilisation in patients with ankylosing spondylitis (AS) treated at a tertiary public health facility over a one-year period. It also investigates the direct and indirect costs for society associated with the treatment of AS.


Ninety AS patients were selected consecutively, and data was analysed retrospectively for one year. Resource utilisation was evaluated through systematic interviews with all patients. Demographic, socioeconomic, and clinical variables were recorded, and questionnaires evaluating quality of life, function, and disease activity were also applied (ASQoL, SF-36, HAQ-S, BASFI, and BASDAI). Estimates of indirect costs were performed using the human-capital approach based on the society perspective.


Most of the patients were men (79%), with a mean age and disease duration of 40 and 16 years, respectively. The mean HAQ-S, BASFI and BASDAI scores were 1, 5, and 4, respectively. The mean ASQoL score for the sample was 8, and the mean Short-Form-36 scores were between 48 (body pain and general health) and 81 (emotional role). The average monthly household income for the group was US$ 520. The patients had an average of 6 outpatient visits, 6 physical therapy visits and 30 laboratory exams per patient, per year. The average total cost for society was US$ 4,597 per patient per year, of which 45% were direct costs and 55% were indirect costs.


Ankylosing spondylitis is a disease that represents a considerable burden to Brazil. It is extremely important to carry out studies that assess the costs of chronic diseases, especially in developing nations, in order to determine the best manner of allocating the already scanty resources in such regions.

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