Vedat Hamuryudan1, Haner Direskeneli2, Ihsan Ertenli3, Murat Inanc4, Yasar Karaaslan5, Fahrettin Oksel6, Suleyman Ozbek7, Salih Pay8, Ender Terzioglu9, Dilara Balkan Tezer10, Basak Hacibedel11, Nurullah Akkoc12. 1. Division of Rheumatology, Department of Internal Medicine, Istanbul University Cerrahpaşa Faculty of Medicine, Turkey. vhamuryudan@yahoo.com. 2. Department of Rheumatology, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey. 3. Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey. 4. Division of Rheumatology, Department of Internal Medicine, Istanbul University Faculty of Medicine, Istanbul, Turkey. 5. Department of Internal Medicine, Hitit University Faculty of Medicine, Çorum; and Rheumatology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey. 6. Division of Rheumatology, Department of Internal Medicine, Ege University Faculty of Medicine, Izmir, Turkey. 7. Division of Rheumatology, Department of Internal Medicine, Çukurova University Faculty of Medicine, Balcalı Hospital, Adana, Turkey. 8. Department of Rheumatology, Gülhane Military Medical Academy, Ankara, Turkey. 9. Department of Internal Medicine, Akdeniz University Faculty of Medicine, Antalya, Turkey. 10. Medical Department, Pfizer Pharmaceuticals, Istanbul, Turkey. 11. Department of Health Economics, Pfizer Pharmaceuticals, Istanbul, Turkey. 12. Division of Rheumatology and Immunology, Department of Internal Medicine, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey.
Abstract
OBJECTIVES: To estimate the annual cost of rheumatoid arthritis (RA) in Turkey by obtaining real-world data directly from patients. METHODS: In this cross-sectional study, RA patients from the rheumatology outpatient clinics of 10 university hospitals were interviewed with a standardised questionnaire on RA-related healthcare care costs. RESULTS: The study included 689 RA patients (565 females) with a mean age of 51.2±13.2 years and mean disease duration of 9.4±7.8 years. The mean scores of the Routine Assessment of Patient Index Data 3 and the Health Assessment Questionnaire-Disability Index (5.08±2.34 and 1.08±0.68, respectively) indicated moderate disease activity and severity for the whole group. One-third of the patients were on biologic agents and 12% had co-morbid conditions. The mean number of annual outpatient visits was 11.7±9.6 per patient. Of the patients, 15% required hospitalisation and 4% underwent surgery. The mean annual direct cost was € 4,954 (median, € 1,805), whereas the mean annual indirect cost was € 2,802 (median, € 608). Pharmacy costs accounted for the highest expenditure (mean, € 2,777; median, € 791), followed by the RA-related consultations and expenses (mean, € 1,600; median, € 696). CONCLUSIONS: RA has a substantial economic burden in Turkey, direct costs being higher than indirect costs. Although both direct and indirect costs are lower in Turkey than in Europe with respect to nominal Euro terms, they are higher from the perspectives of purchasing power parity and gross domestic product. Early diagnosis and treatment of RA may positively affect the national economy considering the positive correlation between health care utilisations and increased cost with disease severity.
OBJECTIVES: To estimate the annual cost of rheumatoid arthritis (RA) in Turkey by obtaining real-world data directly from patients. METHODS: In this cross-sectional study, RApatients from the rheumatology outpatient clinics of 10 university hospitals were interviewed with a standardised questionnaire on RA-related healthcare care costs. RESULTS: The study included 689 RApatients (565 females) with a mean age of 51.2±13.2 years and mean disease duration of 9.4±7.8 years. The mean scores of the Routine Assessment of Patient Index Data 3 and the Health Assessment Questionnaire-Disability Index (5.08±2.34 and 1.08±0.68, respectively) indicated moderate disease activity and severity for the whole group. One-third of the patients were on biologic agents and 12% had co-morbid conditions. The mean number of annual outpatient visits was 11.7±9.6 per patient. Of the patients, 15% required hospitalisation and 4% underwent surgery. The mean annual direct cost was € 4,954 (median, € 1,805), whereas the mean annual indirect cost was € 2,802 (median, € 608). Pharmacy costs accounted for the highest expenditure (mean, € 2,777; median, € 791), followed by the RA-related consultations and expenses (mean, € 1,600; median, € 696). CONCLUSIONS:RA has a substantial economic burden in Turkey, direct costs being higher than indirect costs. Although both direct and indirect costs are lower in Turkey than in Europe with respect to nominal Euro terms, they are higher from the perspectives of purchasing power parity and gross domestic product. Early diagnosis and treatment of RA may positively affect the national economy considering the positive correlation between health care utilisations and increased cost with disease severity.
Authors: Jorge Enrique Machado-Alba; Manuel E Machado-Duque; Andres Gaviria-Mendoza; Juan Manuel Reyes; Natalia Castaño Gamboa Journal: Clin Rheumatol Date: 2020-09-30 Impact factor: 2.980