The Economic Burden of Inflammatory Arthritis: A Systematic Review
Author(s)
Xiaoyu Zhang, MSc1, Jiaru Liu, MSc2, Zhengwei Zhengwei Wang, MSc1, James Galloway, PhD2, Sam Norton, PhD2, Sumeet Singla, MD3, Huajie Jin, PhD2.
1King's College London, LONDON, United Kingdom, 2King's College London, London, United Kingdom, 3Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
1King's College London, LONDON, United Kingdom, 2King's College London, London, United Kingdom, 3Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
OBJECTIVES: Inflammatory arthritis (IA) is a common condition, contributing significantly to healthcare costs and societal burden. This systematic review aims to gather up-to-date cost-of-illness (COI) data on IA from various countries, examine how costs have been measured and estimated, identify the primary cost drivers, and assess the quality of COI study reporting in this field to compile and interpret the available data accurately.
METHODS: An electronic search was performed across four databases—MEDLINE, Embase, the Cochrane Database of Systematic Reviews, and the HMIC to identify COI studies on IA published over the past two decades. All costs were standardized to 2024 US dollar values. The quality of the included studies was evaluated using the Larg and Moss checklist and the modified CHEERS checklist.
RESULTS: From an initial 8847 publications, 79 studies were included in this review. The annual total societal cost per IA patient varied significantly, from US$1,028 in Tunisia to US$84,259 in the USA. Most research focused on rheumatoid arthritis (RA), axial spondyloarthritis (AxSpA), and psoriatic arthritis (PsA), with RA and PsA showing the highest annual societal costs. Countries with lower GDP per capita experienced a disproportionately higher economic burden. Over two-thirds of post-2010 studies showed a shift towards direct healthcare costs as the main financial burden. Productivity losses—primarily due to morbidity—remained substantial, though carer productivity loss was often omitted, despite accounting for over 40% in studies that included it. Methodological gaps were evident, with most studies lacking sensitivity analyses and comprehensive cost perspectives.
CONCLUSIONS: This systematic review demonstrates the economic burden of IA and reports substantial geographic variability. Medication costs were identified as a major factor driving direct healthcare expenditures. The review also identified inconsistencies in methodology and quality among current COI studies, indicating the need for more rigorous adherence to established good practice recommendations in future to fully capture IA's economic impact.
METHODS: An electronic search was performed across four databases—MEDLINE, Embase, the Cochrane Database of Systematic Reviews, and the HMIC to identify COI studies on IA published over the past two decades. All costs were standardized to 2024 US dollar values. The quality of the included studies was evaluated using the Larg and Moss checklist and the modified CHEERS checklist.
RESULTS: From an initial 8847 publications, 79 studies were included in this review. The annual total societal cost per IA patient varied significantly, from US$1,028 in Tunisia to US$84,259 in the USA. Most research focused on rheumatoid arthritis (RA), axial spondyloarthritis (AxSpA), and psoriatic arthritis (PsA), with RA and PsA showing the highest annual societal costs. Countries with lower GDP per capita experienced a disproportionately higher economic burden. Over two-thirds of post-2010 studies showed a shift towards direct healthcare costs as the main financial burden. Productivity losses—primarily due to morbidity—remained substantial, though carer productivity loss was often omitted, despite accounting for over 40% in studies that included it. Methodological gaps were evident, with most studies lacking sensitivity analyses and comprehensive cost perspectives.
CONCLUSIONS: This systematic review demonstrates the economic burden of IA and reports substantial geographic variability. Medication costs were identified as a major factor driving direct healthcare expenditures. The review also identified inconsistencies in methodology and quality among current COI studies, indicating the need for more rigorous adherence to established good practice recommendations in future to fully capture IA's economic impact.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE700
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)