ASSISTANCE COSTS OF RHEUMATOID ARTHRITIS (RA)

J.C. Branco , P. Nero , M. Cruz , S. Ribeiro , J. Amado Silva Rheumatology, Hospital Egas Moniz, Centro de Estudos Economico-empresariais, UAL, Lisbon, PortugalObjectives: The high costs of care for RA, the efficacy and cost of the new biologic agents used in its treatment and the lack of any economical study on RA in Portugal has taken us to make this analysis of the social and economical costs of RA in our country.Methods: This study, with a national and multicentre basis, has evaluated the costs and social impact of RA in 1999, based on two questionnaires applied, in 2000, to the patient and the health service, including social, demographic and clinical data, health care resource utilization, patient expenses, nursing home and life quality indices (HAQ, SF-36). We have calculated the expenses supported by the patient as well as those supported by the health service and the global costs of care for RA.Results: We have included 166 outpatients with RA from 8 centers, 133 (80%) female and 23 (20%) male, being the mean age 55 years ± 12 (SD). The mean age of the onset of the disease was 48 years ± 12 (SD) and the time to diagnosis 2.3 years ± 3.7 (SD). The functional classes (the ACR criteria classification of the global functional status in RA) distribution was: Class I 30 patients (18%); Class II 50 patients (30%); Class III 55 patients (33%); Class IV 31 patients (19%). Seventy-one patients (43%) were retired and 108 (65%) received some kind of economic support for disability. The mean value of HAQ was 1.42 ± 0.77 (SD), of physical SF-36 32.3 ± 9.75 (SD) and mental SF-36 40.1 ± 10.7 (SD). Forty-one percent of the patients needed an health care assistant and 51% had to pay for that assistance. The mean cost for global assistance per patient was 4373 €. This cost, supported in 31.6% by the patient, showed a statistically positive correlation with the functional class (p=0.014).Conclusion: 1) Two thirds of the patients were in functional classes II and III; 2) Two thirds of the patients received some kind of compensation related to the disease; 3) More than 40% of the patients needed an health care assistant; 4) One third of the assistance costs was supported by the patient; 5) The assistance costs were higher in patients with a worse functional status.Citation: , volume , supplement , year 2002, page Session: Health services, economics and outcome research