POS1415 SOCIO-ECONOMIC IMPACT OF SJÖGREN’S SYNDROME IN WESTERN SWITZERLAND: A CROSS-SECTIONAL STUDY
Authors: K. Cunha Rodrigues, A. Grosjean, T. Hügle, A. Dumusc
Journal: Annals of the Rheumatic Diseases (2021)

Background: Several studies investigated the socio-economic impact of Sjögren’s syndrome (SS) showing an increased risk of work disability and a reduced health-related quality of life. SS is also associated with increased direct and indirect healthcare costs. There are no published data about Switzerland, a country with high resources and easy access to healthcare except dental care, which is rarely reimbursed. Objectives: To evaluate the professional and economic impact of SS in patients living in Western Switzerland. Methods: Cross-sectional survey-based study conducted in December 2020, during the pandemic. Patients suffering from SS and living in Western Switzerland (Geneva and Lausanne region) were invited by the regional association of patients with SS to complete a survey assessing the socio-economic impact of SS. Results: Among the 86 patients who were contacted, 55 (64%) completed the survey. Participants were predominantly female (95%) with a mean (SD) age of 54.2 (12.3). Mean (SD) EULAR SS Patient Reported Index (ESSPRI) was 6.5 (1.6), assessing pain, fatigue and dryness. In the working age population (under 65, n=39), 64% of the participants reported to be employed, 88% of whom working part-time. They reported to work 23.3 (10.1) hours per week (mean, SD). 60% reported SS-related work incapacity periods during the past year. 72% of participants had to reduce their working hours and 27% had to change careers due to their medical condition. 16% benefited from an adaptation of their workstation to their health status. In terms of work disability, 27% of the participants depended on disability insurance pension, of whom 38% received a full pension. 16% of the participants applied for a disability pension and were waiting for an administrative decision. A minority of participants (11%) reported to receive a minimum subsistence allowance from the local social service. Participants estimated to pay 2752 CHF (3000) per year (median, IQR) out of their own pocket (Swiss monthly median wage: 6500 CHF) for health care not covered by health insurances. 95% of the patients had to pay for dental medicine costs, at least partially. Public health insurance contributed to dental costs for 44% of the patients and private health insurance for 28% of them. 22% of the patients reported to limit dental care for financial reasons. Conclusion: Two-thirds of the patients with SS remained in active employment, but the majority of them working in part-time, with a substantial loss of income. One third of the patients are work disabled and depend on a disability pension. Dental care was not reimbursed in half of the patients by their health insurance, leading to dental care access restriction for 20% of the patients with SS. Despite a relatively high wage level in Switzerland, SS represents a substantial financial burden for most of the patients. References: [1]Mandl T, Jørgensen TS, Skougaard M, Olsson P, Kristensen LE. Work Disability in Newly Diagnosed Patients with Primary Sjögren Syndrome. J Rheumatol. 2017 Feb;44(2):209-215. [2]Meijer JM, Meiners PM, Huddleston Slater JJ, Spijkervet FK, Kallenberg CG, Vissink A, Bootsma H. Health-related quality of life, employment and disability in patients with Sjogren’s syndrome. Rheumatology. 2009 Sep;48(9):1077-82. [3]Westhoff G, Dörner T, Zink A. Fatigue and depression predict physician visits and work disability in women with primary Sjögren’s syndrome: results from a cohort study. Rheumatology. 2012 Feb;51(2):262-9. [4]Miyamoto ST, Valim V, Fisher BA. Health-related quality of life and costs in Sjögren’s syndrome. Rheumatology. 2019 Feb 15:key370. doi: 10.1093/rheumatology/key370. Epub ahead of print. Disclosure of Interests: None declared