Table 5.

Considerations on costs and QoL

Costs

• The low cost of CSs does not outweigh all the problems related to their use, and adverse events related to CS use also have high economic impact [16] • Optimized CS, in consideration of possible adverse events related to its effects [16], will reduce direct and indirect costs (adequate vs. inadequate use) • The pathologies that develop following use of CS are difficult to put under control (e.g., weight gain, metabolic syndrome) and are associated with a high frequency of other chronic pathologies (e.g., diabetes, osteoporosis) [41, 57] • Iatrogenic diseases and side effects lead to increasing both direct and indirect costs, which are currently not well quantified in the literature [16]; it would be necessary to quantify these costs to better understand the exact impact of these drugs

Quality of life

• CS therapy also has a negative impact on the QoL of patients which stresses the need for correct and optimized use [17–19, 30] • QoL is mainly linked to the CS dosage, as higher doses are associated with worse QoL [17–19, 30]