[Rheuma-VOR-Health economic evaluation of early rheumatological diagnosis : Summary of the G-BA report]

Rheuma-VOR was initiated to reduce long waiting times for specialist diagnosis and guideline-based therapy initiation in rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA).

Rheuma-VOR is a prospective, nonrandomized, multicenter network study with an embedded health economic evaluation. Using a quasi-experimental cohort design and propensity score matching, the intervention group (Rheuma-VOR) was compared with standard care (national database). Direct costs (medications, hospital, and rehabilitation) and indirect costs (productivity losses) were analyzed from a societal perspective.

Rheuma-VOR achieved total savings of € 3.84 million versus standard care, mainly due to fewer hospitalizations (-€ 1.15 million), reduced drug costs (-€ 2.03 million), and improved work capacity (-€ 0.70 million indirect costs). Fewer biologics were prescribed (2.4 % vs. 11.8 %). The model demonstrated a dominant cost-effectiveness profile: similar or better health-related quality of life at lower total costs (Rheuma-VOR: € 2,445.17/patient, 95 % confidence interval [CI] € 1,955.79-€ 3,041.50; standard care: € 3,107.33/patient, 95% CI € 1,958.28-€ 3,997.62). Annual coordination center costs (€ 272.35/patient) were fully offset by savings.

Structured, cross-sectoral care models like Rheuma-VOR reduce diagnostic delays, optimize resource use, and are economically sustainable. Long-term benefits include additional savings through prevention of irreversible damage.