Abstract
Rheumatoid arthritis (RA) is associated with increased costs generated by resource utilization and loss of work productivity. We have studied 206 RA patients and analyzed indirect costs of RA in Romania (estimated using the human capital approach) in comparison with reported data for other countries. Data were collected using self-reported questionnaires. The average age at inclusion was 55 years, with mean disease duration of 9.4 years; 55 patients had permanent work disability due to RA; 6.35 days of sick leave per patient were reported for the entire year of follow-up; the cost of permanent work disability was 1256€ per patient. From a societal perspective, the average indirect costs for a patient with RA were 1506€, significantly lower than the ones reported by other countries, especially due to the low monetary value of paid work.
Highlights
Rheumatoid arthritis (RA) is the most frequent inflammatory joint disease with a prevalence of 0,72% according to data published in 2010. [1]
All the patients existing in the electronic database of a university tertiary rheumatology center within the stated time period (n = 3951) were screened for the following inclusion criteria: a recorded diagnosis of RA according to each attending rheumatologist, proof of RA-specific treatment with csDMARDs and/or bDMARDs, age above 18 years, and acceptance to complete a self-reported questionnaire at 6-month intervals and return it by post
The age of patients on bDMARDs was significantly lower, this had no effect upon the status of work activity, as the average age in the cohort was 54.9 ± 12.7 years, indicating participants who are professionally active
Summary
Rheumatoid arthritis (RA) is the most frequent inflammatory joint disease with a prevalence of 0,72% according to data published in 2010. [1]. The friction cost method estimates the value of human capital when another person from the unemployment pool replaces the present value of a worker’s future earnings until the sick or impaired worker returns or is eventually replaced This period refers to the time theoretically necessary for the replacement of an ill employee with another person from the general population, which is available for work, but not yet employed. This involves precocious, aggressive treatment of the active forms of the disease, aiming for disease remission as the treatment objective, meaning a complete control of the symptoms and of the inflammatory process in order to prevent irreversible destructive joint lesions To achieve this therapeutic objective, the present treatment recommendations propose the initial use of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs; small molecules, obtained by chemical synthesis, usually with a low price), followed by biological DMARDs (complex pharmaceutical preparations, based on biotechnology in cell cultures, at high costs) only for cases where csDMARDs were inefficient (the patient did not attain disease remission) or where they produced significant side effects [21]. This is the first study of the appraisal of RA costs in Romania, with specific reference to the indirect costs of the disease
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