Johan Andre Liseth Hansen

• Hansen, Johan; Tarkia, Miikka; Vasilevska, Marija; Sandin, Patrik; Asllanaj, Eralda & Wammes, Karlijn [Show all 8 contributors for this article] (2026). Trends in Healthcare Costs in Heart Failure and Its Clinical Phenotypes During the Implementation of SGLT2 Inhibitors: A Finnish Registry Study. ClinicoEconomics and Outcomes Research. Volume 18, p. 11–11. doi: 10.2147/ceor.s576426. Full text in Research Archive
• Hansen, Johan A. Liseth; Skira, Meghan & Wangen, Knut Reidar (2026). Migraine treatment and work absence trends before and after introduction of calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs): A nationwide Swedish register study. Cephalalgia Reports. 9. doi: 10.1177/25158163261421617. Full text in Research Archive Show summary

  Aim Calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) are an important new preventative medication class for migraine treatment. While clinical efficacy of CGRP mAbs is well established, less is known about their impact on treatment patterns and work absence. This study examined migraine treatment and work absence patterns before and after CGRP mAbs were reimbursed in 2019 in Sweden. Methods We conducted a nationwide non-interventional observational study using Swedish administrative data. Patients with a hospital diagnosis of migraine between 2015 and 2021 were included and split into three cohorts based on the year of their diagnosis: 2015–2016, 2017–2018 and 2019–2021. We assessed time to new treatments after diagnosis using inverse probability weights to adjust for baseline differences. Work absence due to sick leave and disability was assessed via a two-part regression model of the estimated probability of any work absence and the average number of absence days conditional on non-zero absence days in the year following diagnosis. Results In total, 40,247 patients were included. The proportion dispensed a new preventative treatment after diagnosis rose from 16.2% in the 2015–2016 cohort to 22.4% in the 2019–2021 cohort. Patients diagnosed in 2019–2021 initiated more new preventative treatments compared to earlier cohorts. CGRP mAbs composed a substantial part of the treatment landscape for those diagnosed in 2019–2021, with 9.2% of patients receiving them as the first new treatment after diagnosis. The regression models showed a lower probability of work absence in the 2019–2021 cohort compared to the earlier cohorts, however the total number of absence days conditional on non-zero days varied across the study cohorts. Conclusions After market entry of CGRP mAbs, newly diagnosed patients with migraine initiated and cycled through preventative migraine medications more rapidly than those diagnosed in earlier years. These changes were accompanied by a modest decline in the probability of work absence. Faster cycling through preventative medication after the entry of CGRP mAbs in Sweden may indicate that patients and physicians want to start CGRP mAb treatment as early as possible.

• Langdahl, Bente L.; Lorentzon, Mattias; Borgen, Tove Tveitan; Bajtner, Estelle; Kaarill, Tanja & Alstad, Cecilie [Show all 12 contributors for this article] (2025). Treatment patterns of romosozumab in postmenopausal women with severe osteoporosis in Denmark: findings from the ROmosozumab in Scandinavia real-world Evidence Study (ROSES). Osteoporosis International. ISSN 0937-941X. 37, p. 167–178. doi: 10.1007/s00198-025-07756-y. Full text in Research Archive Show summary

  Purpose To describe patient and prescriber characteristics and factors associated with utilization of romosozumab in Denmark. Methods This registry‑based Danish retrospective cohort study comprised females aged ≥ 50 receiving osteoporosis medication from September 2020 − October 2023. Three cohorts were identified: those treated with romosozumab (cohort 1), those with osteoporosis‑related fracture within the last three years treated with other osteoporosis medications (cohort 2), and those without osteoporosis‑related fracture within three years prior to initiating other osteoporosis medications (cohort 3). Patient and prescriber characteristics are presented by cohort. Factors associated with receiving romosozumab and transition of treatment are reported. Results Overall, 149,395 patients were included. Cohort 1 (n = 622) was younger, had lower proportions of comorbidities and use of glucocorticoids than cohorts 2 (n = 29,021) and 3 (n = 119,752). In cohort 1, 277 patients (44.5%) were osteoporosis treatment‑naïve and the majority received their index treatment from secondary endocrinological care. The median duration from romosozumab initiation to a recorded treatment transition was 350 days; most patients transitioned between 11–15 months to zoledronate (53.5%), alendronate (18.9%), or denosumab (13.5%). Conclusion This study provides real-world insight into patient and prescriber characteristics, and patterns and factors of romosozumab use across Denmark. Whilst a notable proportion of patients received romosozumab first in sequential therapy, there is still opportunity to optimize bone mineral density (BMD) outcomes with osteoanabolic agents used first, followed by an antiresorptive, in patients at high fracture risk. Of romosozumab-treated patients with 15 months follow-up data, most were assumed to continue romosozumab for 11–15 months when treatment transition was recorded. Mini abstract Real-world data from Danish registries were used to describe treatment patterns with romosozumab and other anti-osteoporosis treatments in postmenopausal women with osteoporosis. The study found romosozumab‑treated patients were younger and had fewer comorbidities than other osteoporosis patients. Among romosozumab-treated patients, 44.5% were treatment-naïve and most continued with romosozumab for 11–15 months.

• Kvien, Tore Kristian Aaserud; Hansen, Johan L.; Böttger, Robert; Freitas, Rita; Jastorff, Jan & Mascia, Elena [Show all 7 contributors for this article] (2025). NSAID Use, Gastrointestinal Complications, and Burden of Disease in Osteoarthritis: Nordic Registry Study with Emphasis on Patients Below 60 Years. Rheumatology and therapy. ISSN 2198-6576. doi: 10.1007/s40744-025-00803-4. Full text in Research Archive
• Hansen, Johan Andre Liseth & Wangen, Knut Reidar (2024). Trajectories of opioid use among patients with low back pain: Association to work absence. European Journal of Pain. ISSN 1090-3801. doi: 10.1002/ejp.4706. Full text in Research Archive Show summary

  Background Low back pain (LBP) is a leading reason for opioid use and a closer examination of opioid use and productivity losses among these patients is needed. We identify opioid use trajectories using a group-based trajectory model (GBTM) and estimate productivity losses across the trajectories. Methods Patients diagnosed with LBP in Swedish specialty care between 2011 and 2015, between the ages of 20 and 60, were included. Two GBTMs were estimated on monthly opioid use (converted to oral morphine equivalents) during the two 12-month periods preceding and following diagnosis. Productivity losses were estimated using the human-capital approach. Results In total, 147,035 patients were included. The mean age at diagnosis was 43 years of age and 49% of the patients were male. A qualitative assessment of the identified groups in the GBTM models was made based on the patterns of opioid use. We chose three pre-diagnosis groups characterized as ‘Pre-low’ (N = 109,492), ‘Pre-increase’ (N = 27,336) and ‘Pre-high’ (N = 10,207). Similarly, four post-diagnosis groups were chosen and characterized as ‘Post-low’ (N = 73,287), ‘Post-decrease’ (N = 39,446), ‘Post-moderate’ (N = 20,001) and ‘Post-high’ (N = 13,595). Only 50% of the patients in the ‘Pre-high’ group were in the ‘Post-high’ group. The total productivity losses by the pre-diagnosis groups were more than 2.7 billion Euros over the total 6-year study period. Conclusion This study highlights how patients with LBP and high use of opioids are highly correlated before and after diagnosis. Patients with high use of opioids also exhibit high work absence and productivity losses. Significance Statement This was the first study to estimate trajectories of opioids in the two time periods before and after a diagnosis of low back pain. For the first time, productivity losses were also estimated across the identified opioid use trajectories.

• Stubhaug, Audun; Hansen, Johan Andre Liseth; Hallberg, Sara; Gustavsson, Anders; Eggen, Anne Elise & Nielsen, Christopher Sivert (2024). The costs of chronic pain - Long‐term estimates. European Journal of Pain. ISSN 1090-3801. 28(6), p. 960–977. doi: 10.1002/ejp.2234. Full text in Research Archive Show summary

  Background: Chronic pain is a condition with severe impact on many aspects of life, including work, functional ability and quality of life, thereby reducing physical, mental and social well-being. Despite the high prevalence and burden of chronic pain, it has received disproportionally little attention in research and public policy and the societal costs of chronic pain remain largely unknown. This study aimed to describe the long-term healthcare and work absence costs of individuals with and without self-identified chronic pain.<p> <p>Methods: The study population were participants in two Norwegian population health studies (HUNT3 and Tromsø6). Participants were defined as having chronic pain based on a self-reported answer to a question on chronic pain in the health studies in 2008. Individuals in the study population were linked to four national register databases on healthcare resource use and work absence. <p>Results: In our study, 36% (n=63,782) self-reported to have chronic pain and the average years of age was 56.6. The accumulated difference in costs between those with and without chronic pain from 2010 to 2016 was €55,003 (CI: 54,414–55,592) per individual. Extrapolating this to the entire population suggests that chronic pain imposes a yearly burden of 4% of GDP. Eighty per cent of the costs were estimated to be productivity loss. <p>Conclusion: Insights from this study can provide a greater understanding of the extent of healthcare use and productivity loss by those with chronic pain and serve as an important basis for improvements in rehabilitation and quality of care, and the education of the public on the burden of chronic pain. <p>Significance: This was the first study to estimate the economic burden associated with chronic pain in the general population using linked individual-level administrative data and self-reported survey answers. We provide calculations showing that annual costs of chronic pain may be as high as €12 billion or 4% of GDP. Findings from this study highlight the need for a greater understanding of the substantial healthcare use and productivity losses among individuals with chronic pain.

• Hansen, Johan Andre Liseth; Fast, Thomas & Wangen, Knut Reidar (2023). Productivity Loss Across Socioeconomic Groups Among Patients With Low Back Pain or Osteoarthritis: Estimates Using the Friction-Cost Approach in Norway. PharmacoEconomics (Auckland). ISSN 1170-7690. doi: 10.1007/s40273-023-01269-4. Full text in Research Archive
• Hansen, Johan Andre Liseth; Heilig, Markus; Kalso, Eija; Stubhaug, Audun; Knutsson, Douglas & Sandin, Patrik [Show all 11 contributors for this article] (2023). Problematic opioid use among osteoarthritis patients with chronic post-operative pain after joint replacement: analyses from the BISCUITS study. Scandinavian Journal of Pain. ISSN 1877-8860. 23(2), p. 353–363. doi: 10.1515/sjpain-2022-0137. Full text in Research Archive Show summary

  Objectives Opioids are commonly used to manage pain, despite an increased risk of adverse events and complications when used against recommendations. This register study uses data of osteoarthritis (OA) patients with joint replacement surgery to identify and characterize problematic opioid use (POU) prescription patterns. Methods The study population included adult patients diagnosed with OA in specialty care undergoing joint replacement surgery in Denmark, Finland, Norway, and Sweden during 1 January 2011 to 31 December 2014. Those with cancer or OA within three years before the first eligible OA diagnosis were excluded. Patients were allocated into six POU cohorts based on dose escalation, frequency, and dosing of prescription opioids post-surgery (definitions were based on guidelines, previous literature, and clinical experience), and matched on age and sex to patients with opioid use, but not in any of the six cohorts. Data on demographics, non-OA pain diagnoses, cardiovascular diseases, psychiatric disorders, and clinical characteristics were used to study patient characteristics and predictors of POU. Results 13.7% of patients with OA and a hip/knee joint replacement were classified as problematic users and they had more comorbidities and higher pre-surgery doses of opioids than matches. Patients dispensing high doses of opioids pre-surgery dispensed increased doses post-surgery, a pattern not seen among patients prescribed lower doses pre-surgery. Being dispensed 1–4,500 oral morphine equivalents in the year pre-surgery or having a non-OA pain diagnosis was associated with post-surgery POU (OR: 1.44–1.50, and 1.11–1.20, respectively). Conclusions Based on the discovered POU predictors, the study suggests that prescribers should carefully assess pain management strategies for patients with a history of comorbidities and pre-operative, long-term opioid use. Healthcare units should adopt risk assessment tools and ensure that these patients are followed up closely. The data also demonstrate potential areas for further exploration in improving patient outcomes and trajectories.

• Schepman, Patricia; Robinson, Rebecca; Blakeman, Karin Hygge; Wilhelm, Stefan; Beck, Craig & Hallberg, Sara [Show all 10 contributors for this article] (2023). Factors influencing quality of life in patients with osteoarthritis: analyses from the BISCUITS study. Scandinavian Journal of Pain. ISSN 1877-8860. 23(1). doi: 10.1515/sjpain-2021-0213. Full text in Research Archive
• Nielsen, Lars Arendt; Schepman, Patricia; Blakeman, Karin Hygge; Wilhelm, Stefan; Robinson, Rebecca & Beck, Craig [Show all 8 contributors for this article] (2022). Prescription patterns and predictors of unmet pain relief in patients with difficult-To-Treat osteoarthritis in the Nordics: Analyses from the BISCUITS study. Scandinavian Journal of Pain. ISSN 1877-8860. doi: 10.1515/sjpain-2021-0211. Full text in Research Archive Show summary

  Objectives: Osteoarthritis (OA) is one of the leading causes of disability worldwide. Pain is the most important symptom in OA, driving medical care, disability, reduced functionality, and decreased quality of life. The objective of this study was to describe prescription patterns of difficult to-treat OA and explore possible predictors of unmet pain relief in Nordic patients. Methods: This observational cohort study included patients with a confirmed diagnosis of OA (index date) in specialty care in Sweden, Norway, Finland and Denmark between 1 January 2011 and 31 December 2012 who were followed for up to 5 years. Four subgroups were pre-defined to characterize difficult-to-treat OA: (1) ≥2 chronic comorbidities in the 3-year pre-index period; (2) top 10% of healthcare resource users, 1-year post-index; (3) ≥3 types of prescription pain medications during pre-index period to first year postindex, with ≥30 days between types; (4) having a contraindication to a nonsteroidal anti-inflammatory drug (NSAID). Patient characteristics, prescription patterns and predictors of unmet pain relief (defined as persistent opioid use, using several types of opioids or long-term NSAID use) were analyzed. Results: We identified 288,174 OA patients and the average age was 63.5 years at time of diagnosis and 58% of them were female. After 5 years, 35–50% of the patients defined as ‘Difficult-to-treat’ had ≥1 prescription of opioids, compared to 20–25% of all OA patients (p-value <0.05). Comorbidities and disability pension were strong predictors of unmet pain relief (p-value <0.001). Conclusions: This study shows a substantial use of pain medications (NSAID and opioids) in difficult-to-treat OA patients. These findings suggest that pain may be inadequately managed in a considerable number of patients with OA, particularly those with contraindications to an NSAID. A high comorbid and socioeconomic burden are relevant risk factors among patients who continue to use opioids for a long period of time.

• Lauppe, Rosa; Hansen, Johan Andre Liseth; Fornwall, Anna; Johansson, Katarina; Rozenbaum, Mark H & Strand, Anne Mette [Show all 11 contributors for this article] (2022). Healthcare resource use of patients with transthyretin amyloid cardiomyopathy. ESC Heart Failure. doi: 10.1002/ehf2.13913. Full text in Research Archive
• Lauppe, Rosa; Hansen, Johan Andre Liseth; Fornwall, Anna; Johansson, Katarina; Rozenbaum, Mark H. & Strand, Anne Mette [Show all 11 contributors for this article] (2022). Prevalence, characteristics, and mortality of patients with transthyretin amyloid cardiomyopathy in the Nordic countries. ESC Heart Failure. 9(4), p. 2528–2537. doi: 10.1002/ehf2.13961. Full text in Research Archive
• Lauppe, Rosa Elisabeth; Hansen, Johan Andre Liseth; Gerdesköld, Christian; Rozenbaum, Mark H.; Strand, Anne Mette & Vakevainen, Merja [Show all 10 contributors for this article] (2021). Nationwide prevalence and characteristics of transthyretin amyloid cardiomyopathy in Sweden. Open heart. 8(2), p. 1–9. doi: 10.1136/openhrt-2021-001755. Full text in Research Archive

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• Hansen, Johan Andre Liseth; Lizardi, Eduardo Alberto Ramirez & Linde, Astrid de (2025). The impact of severe illness on the family: Evidence from cancer shocks. Full text in Research Archive Show summary

  Presentasjon på ASHECon 2025

• Hansen, Johan Andre Liseth (2026). Productivity losses and costs associated with pain and pain treatments. Universitetet i Oslo. ISSN 9788234807558. Full text in Research Archive Show summary

  Conditions and diseases related to pain place a high burden on healthcare systems and the economy. The aim of this thesis was to quantify this burden. This was examined through three papers, each focusing on a specific aspect of pain in society with an overarching focus on the productivity losses due to work absences. In paper 1, productivity losses were estimated among patients with low back pain and/or osteoarthritis in Norway. Productivity losses were estimated using the friction-cost approach. There was a great variation of friction cost estimates due to the model specification. Productivity losses also varied across educational groups, where losses were higher for those with higher education. In paper 2, a cost-of-illness study of chronic pain was conducted. Individuals with chronic pain were identified through self-reported answers in two Norwegian population health surveys. Those with self-identified chronic pain had between 50-70% higher healthcare costs and 120-150% higher productivity losses per year compared to those without self-identified pain. In the 3rd paper, groups of opioid users with low back pain were identified using a data-driven group-based trajectory model. The trajectory model identified distinct groups of opioid users based on opioid use before and after diagnosis. Patients in the high-use groups had substantially higher productivity losses as well as poorer socioeconomic status than patients in the other groups. These findings highlight the association between high use of opioids and socioeconomic status. Findings in these three papers show that there are substantial productivity losses in society due to lost economic production among individuals with chronic pain and other pain conditions. The healthcare system may therefore not only focus on pain relief interventions, but also on interventions that are directly aimed at keeping these individuals in the work force and accommodate their treatment such that they can keep working.

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