PMS11 EPIDEMIOLOGY, USE OF RESOURCES AND COST OF MODERATE TO SEVERE RHEUMATOID ARTHRITIS IN ARGENTINA: AN EXTENSIVE REVIEW WITH EXPERT ELICITATION

Abstract

Rheumatoid arthritis (RA) is a disabling disease associated with a high use of resources for treatment (e.g. biologic drugs) and with costs related to productivity losses. There is scarce information on the epidemiology and economic burden of rheumatoid arthritis (RA) in Argentina. The objective was to collect information about key epidemiological parameters and estimate the cost of moderate to severe RA. We conducted a literature search on PUBMED and LILACS. In addition to this, we resorted to a consensus of experienced local rheumatologists using a modified Delphi panel method to find actual parameters for Argentina. We estimated resource usage rates and direct medical costs, based on the database of unit costs of the Institute for Clinical Effectiveness and Health Policy in Argentina, and indirect costs through the human capital approach. Costs were expressed in United States Dollars (USD), November 2017. The reported prevalence of RA in Argentina was 0.94% (95%CI: 0.86 – 1.02) with an estimated yearly incidence rate of 19 new cases every 100,000 persons/year (95%CI: 17 - 20). In 2017 the estimated cost of disease-modifying drugs was USD 54,405 per patient per year. The cost attributed to serious infections associated with the disease was nearly USD 2474. The per-patient cost of bilateral knee replacement exceeded USD 5276, and the cost of total hip replacement was USD 9196. Both types of costs increased with higher Health Assessment Questionnaire band. HAQ is a widely used disability assessment tool. We provide useful information on epidemiological and cost parameters of moderate to severe RA in the era of biologic agents in Argentina.