Costs and Resource Optimization in the Rheumatoid Arthritis Care Pathway: A TDABC-Based Analysis in a Clinic in São Paulo
Author(s)
Marcelo E. Nita, MSc, PhD, MD1, Camila Azevedo, MSc1, Thiago Wollinger, MBA2, Luana Lopes, MSc1, Ricardo Bueno, BA, MHA, PhD3, Yohanna Ramires, MSc3, Nanci Utida, MD3, Tiago José de Almeida Silva, MSc3;
1MAPESolutions, São Paulo, Brazil, 2MAPESolutions, Researcher, São Paulo, Brazil, 3Organon, São Paulo, Brazil
1MAPESolutions, São Paulo, Brazil, 2MAPESolutions, Researcher, São Paulo, Brazil, 3Organon, São Paulo, Brazil
OBJECTIVES: The objective of this study was to utilize the Time-Driven Activity-Based Costing (TDABC) method to evaluate the cost of care delivery in the Rheumatoid Arthritis (RA) care pathway at a private healthcare center in Sao Paulo, Brazil.
METHODS: The TDABC was based on established care protocol, involving the systematic measurement of processes, activities, resources, and their associated costs. Detailed data on the time duration of each activity and the corresponding resource expenses were collected, medicine costs were collected from CMED the Brazilian price regulation authority. A comprehensive analysis of the care pathway, ranging from initial assessment to treatment management and follow-up, was conducted to identify the primary cost drivers.
RESULTS: The application of TDABC in the rheumatoid arthritis care pathway provided valuable insights into the costs incurred at each stage of the process. The main cost drivers through care journey steps were initial consultation cost R$41.70 (USD7.15), while the diagnostic phase amounted to R$1,903.04 (USD326.50). The treatment of rheumatoid arthritis represented a substantial investment of R$24,847.90 (USD4,263.07), and the ongoing monitoring and management cost R$1,136.70 (USD195.02). The use of biosimilar medicines, considering a single dose, results in a reduction in expenses of R$ 8,625.57 (USD1,479.86). This amount indicates savings for the system of more than 67% in the cost of treating these patients. These figures emphasize the significance of accurate early diagnosis and effective interventions to optimize resource efficiency and cost reduction during the treatment process.
CONCLUSIONS: The implementation of TDABC in the rheumatoid arthritis care pathway at the healthcare center provided a comprehensive understanding of the associated costs of care. Considering the specific costs, the highest involves the biological medicines and the diagnosis, these insights can inform decision-making, resource allocation, and process optimization, thereby improving the efficiency and value of care provided to rheumatoid arthritis patients in Brazil.
METHODS: The TDABC was based on established care protocol, involving the systematic measurement of processes, activities, resources, and their associated costs. Detailed data on the time duration of each activity and the corresponding resource expenses were collected, medicine costs were collected from CMED the Brazilian price regulation authority. A comprehensive analysis of the care pathway, ranging from initial assessment to treatment management and follow-up, was conducted to identify the primary cost drivers.
RESULTS: The application of TDABC in the rheumatoid arthritis care pathway provided valuable insights into the costs incurred at each stage of the process. The main cost drivers through care journey steps were initial consultation cost R$41.70 (USD7.15), while the diagnostic phase amounted to R$1,903.04 (USD326.50). The treatment of rheumatoid arthritis represented a substantial investment of R$24,847.90 (USD4,263.07), and the ongoing monitoring and management cost R$1,136.70 (USD195.02). The use of biosimilar medicines, considering a single dose, results in a reduction in expenses of R$ 8,625.57 (USD1,479.86). This amount indicates savings for the system of more than 67% in the cost of treating these patients. These figures emphasize the significance of accurate early diagnosis and effective interventions to optimize resource efficiency and cost reduction during the treatment process.
CONCLUSIONS: The implementation of TDABC in the rheumatoid arthritis care pathway at the healthcare center provided a comprehensive understanding of the associated costs of care. Considering the specific costs, the highest involves the biological medicines and the diagnosis, these insights can inform decision-making, resource allocation, and process optimization, thereby improving the efficiency and value of care provided to rheumatoid arthritis patients in Brazil.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE174
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)