OBJECTIVES: There is a lack of knowledge and training among general practitioners in Latin America for the assertive diagnosis of rheumatoid arthritis (RA), which leads to diagnostic errors with the respective cost overruns for health systems. The objective of the study was to quantify the costs of treatment in patients with a misdiagnosis of RA.

METHODS: We analyzed 774 clinical records of patients with presumptive diagnosis of RA referred by insurers to a comprehensive care center in RA to confirm or rule-out the diagnosis. A strict screening protocol-process was applied to the patients that included the use of physical examination by rheumatologist, clinical records, serological markers and imaging (X-Ray, ultrasound and/or magnetic resonance imaging of hands/feet). The cost of treatment of the disease in the first year was based on the treat-to-target strategy; also, the treatment of the most frequent diagnosis found according to the management guideline was estimated. Costs were estimated in american dollars (USD) of 2018, using an exchange rate of 2,951 COP per dollar.

RESULTS: After the screening protocol-process, 74.8% (579/774) of the patients were classified as having Osteoarthritis (OA), being the most frequent diagnosis. Only 21.8% (169/774) were confirmed to have RA and 3.3% were classified in other diagnoses. The cost per year of treatment per patient of the RA was $ 4,979.6 USD and for the OA of $ 483.6 USD. The additional cost of the 579 patients who had received treatment for RA if it has not been reclassified would be $ 28,551,879.60 USD per year.

CONCLUSIONS: The correct diagnosis of RA performed through a protocol-process supported in a comprehensive evaluation, allows disease management, where patients receive the appropriate treatment for their condition without burdening unnecessary costs to insurers and in general to the health systems.