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Cost of rheumatoid arthritis

Clinical bottom line

The annual average medical cost of rheumatoid arthritis is US$5700 (1996 dollars). A systematic review of cost of illness studies provides insights into results of such studies in rheumatoid arthritis, and how they may be done better.


Health economics is a complicated business, and the results are often hard to understand for ordinary mortals. A systematic review of such studies is a rare beast. Whatever their deficiencies, they help provide an insight into resource use.

Reference

NJ Cooper. Economic burden of rheumatoid arthritis: a sytematic review. Rheumatology 2000 39: 28-33.

Review

Four computerised databases were searched for English-language papers. Costs were converted to US$ 1996 using a consumer price index for medical care. Seven key elements of cost of illness studies are set out, and included papers measured against them.

Results

There were fifteen articles, 11 from the USA, one from the UK, one from Canada, one from Sweden and one from Holland. Three of the seven criteria were met by almost all the studies, but the remaining four by only a few.

The average annual cost of medical care for rtheumatoid arthritis was $5700.

Figure: Individual results from studies in which annual mean medical costs were calculated. The red line indicates the average.





The highest costs came from studies with most severe disease and youngest patients. In-patient costs were the largest component (range 17% to 88%), and cost of medication ranged between 8% and 24%. Days lost from work were 3 to 30 days a year.

Comment

This is a useful review from which much can be learned. There were possible differences between studies depending on their architecture (cohort, case-control) or setting (clinical or community based). In UK terms the cost is about £3,500 a year.

Understanding the costs of medical management should be part of optimising treatment. It is an inexact science, and this paper will help move that forward.