A Prevalence-Based Study to Estimate Cost of Illness of Rheumatoid Arthritis in a Tertiary Care Hospital in India

Abstract

Background: Rheumatoid arthritis (RA) is a chronic progressive inflammatory condition with high cost of management and significant impact on the patient and healthcare system. Hence, there is a need to estimate and analyze the economic impact of RA. Materials and Methods: It was a cross-sectional prospective follow-up single-center study at a tertiary care hospital conducted over a period of 02 years and 06 months from September 2019 to February 2022 after ethical committee clearance. Results: A total of 189 RA patients were included after excluding 15 patients. The male-to-female ratio was 0.687. The mean age of the study population was 44.74 ± 5.2 years. The mean yearly average cost of management of RA was Rs 29155.1 ± 18234.1, of which 49.6% was direct medical, 19.4% was direct non-medical, and 31% was indirect costs. Of average direct medical costs, cost toward non-steroidal anti-inflammatory drugs (NSAIDs) was 3.1%; conventional disease-modifying antirheumatic drugs (DMARDs) was 36.3%; and laboratory, radiology investigations, and consultations was 6.4%, 1.48%, and 12.3%, respectively. Factors, such as longer duration of treatment, use of biologic DMARDs, loss of productive workdays, extraarticular manifestations, and management of complications, were associated with higher cost of treatment of RA. Conclusions: This study quantifies the economic burden of the RA by measuring costs incurred toward all aspects of the patient’s life including the indirect costs due to loss of workdays. The knowledge of cost will help in financial management by patients and healthcare providers.