Analysis of direct medical and nonmedical costs for care of rheumatoid arthritis patients using the large cohort database, IORRA

• Published in: Modern rheumatology Vol. 23; no. 4; pp. 742 - 751
• Main Authors: Tanaka, Eiichi, Hoshi, Daisuke, Igarashi, Ataru, Inoue, Eisuke, Shidara, Kumi, Sugimoto, Naoki, Sato, Eri, Seto, Yohei, Nakajima, Ayako, Momohara, Shigeki, Taniguchi, Atsuo, Tsutani, Kiichiro, Yamanaka, Hisashi
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01-07-2013; Informa Healthcare
• Subjects: Adult; Aged; Antirheumatic Agents - economics; Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - economics; Correlation analysis; Databases, Factual; Female; Health Care Costs; Health care expenditures; Humans; Japan; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Orthopedics; Quality of care; Quality of Life; Quality-Adjusted Life Years; Rheumatoid arthritis; Rheumatology; Rheumatology - economics; Surveys and Questionnaires; Japan; Disability; EQ-5D; Medical cost; Rheumatoid arthritis; Health Assessment Questionnaire
• ISSN: 1439-7595; 1439-7609
• DOI: 10.1007/s10165-012-0729-3

Objectives
Our goal was to determine the annual direct medical and nonmedical costs for the care of patients with rheumatoid arthritis (RA) using data from a large cohort database in Japan.
Methods
Direct medical costs [out of pocket to hospitals and pharmacies and for complementary and alternative medicine (CAM)] and nonmedical costs (caregiving, transportation, self-help devices, house modifications) were determined for RA patients who were participants in the Institute of Rheumatology, Rheumatoid Arthritis (IORRA) studies conducted in October 2007 and April 2008. Correlations between these costs and RA disease activity, disability level, and quality of life (QOL) were assessed.
Results
Data were analyzed from 5,204 and 5,265 RA patients in October 2007 and April 2008, respectively. The annual direct medical costs were JPY132,000 [out of pocket to hospital (US$1 = JPY90 in 2007)], JPY84,000 (out of pocket to pharmacy), and JPY146,000 (CAM). Annual direct nonmedical costs were JPY105,000 (caregiving), JPY22,000 (transportation), JPY30,000 (self-help devices), and JPY188,000 (house modifications). Based on the utilization rate for each cost component, the annual medical and nonmedical costs for each RA patient were JPY262,136 and JPY61,441, respectively. Costs increased with increasing RA disease activity and disability level or worsening quality of life (QOL).
Conclusions
Based on the IORRA database, patients with RA bear heavy economic burdens that increase as the disease is exacerbated. The results also suggest that the increase in medical and nonmedical costs may be ameliorated by the proactive control of disease activity.