Presentation (CTI)

OBJECTIVES: To assess the societal burden of rheumatoid arthritis (RA) in Morocco, including direct, indirect, and intangible costs among patients receiving biologic therapies, with particular attention to social impacts not routinely captured in conventional economic evaluations.
METHODS: A descriptive, observational ambispective study was conducted among 110 patients with RA treated with biologic therapies at El Ayachi Hospital between 2019 and 2020. Data was obtained from patient interviews and medical records, allowing direct, patient-level assessment of economic and social outcomes. Direct costs were derived from patient-reported expenditures and medical records; when unavailable, standardized unit costs were based on national reference tariffs. Indirect costs related to productivity loss and intangible impacts were captured through patient interviews. All costs were analyzed from a societal perspective.
RESULTS: The mean annual direct cost per patient was $7,659, with medical costs accounting for 98%, largely driven by biologics (67%). From a societal perspective, costs were mainly covered by public funding (47%) and insurance (39%), while out-of-pocket (OOP) expenses represented 14%. Despite this, most patients lived in vulnerable conditions (household income < $250/month), with OOP costs representing approximately one-third of annual household income. Indirect costs were substantial, with productivity losses averaging $2,337 per patient per year, and 38% of patients stopping work or studies. Beyond economic burden, notable social impacts were observed, including reduced daily activities, marital disruption, delayed or foregone marriage, and long-term consequences, particularly among women.
CONCLUSIONS: RA imposes a substantial societal burden in Morocco, combining significant economic impact with underrecognized social consequences, while real-world patient-level evidence highlights persistent financial vulnerability despite existing coverage mechanisms.