Cost of rheumatoid arthritis in a selected population from Argentina in the prebiologic therapy era

Erika Catay,¹ Cecilia Castel del Cid,¹ Lorena Narváez,¹ Edson J Velozo,¹ Javier E Rosa,^1,2 Luis J Catoggio,^1,2 Enrique R Soriano<sup>1,2

1</sup>Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, ²University Institute Hospital Italiano de Buenos Aires, School of Medicine, PM Catoggio Foundation, Buenos Aires, Argentina

Background: The present study aimed to estimate the cost of rheumatoid arthritis and its components in a university hospital-based health management organization in Argentina, during the prebiologic era.
Methods: A one-year (2002) observational prevalence, cost-of illness study of patients with rheumatoid arthritis from the societal perspective was performed in a hospital-based health management organization population. Direct medical costs were obtained using administrative databases. Direct nonmedical and indirect costs were obtained from a semistructured questionnaire. Indirect costs included work absenteeism, permanent work disability, and housework lost for housewives, using the human capital approach. Costs are expressed in 2002 US dollars per patient per year.
Results: A total of 165 patients (84% females), of mean age 61 ± 15 years and with a mean disease duration of 8.5 ± 8.3 years were included. Mean total direct medical costs were US$1862 (95% confidence interval [CI] 828–2899). Mean direct nonmedical costs were US$222 (95% CI 149–294). Mean indirect costs were US$1008 (95% CI 606–1412). The annual mean total cost was US$3093 without biologics. Hospitalizations represented 73% of total direct medical costs while drugs and outpatient procedures represented 16% and 8% of total direct medical costs, respectively. Sixty percent of the total costs were related to direct medical costs, while indirect costs represented 33% of total costs.
Conclusion: In our population, annual mean total costs in the prebiologic therapy era were mainly driven by direct medical costs. Even without the use of biologic agents, rheumatoid arthritis represents an important burden for society in developing countries.

Keywords: rheumatoid arthritis, economics, burden of illness, cost of illness