OBJECTIVES

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatological disease in childhood. It is divided into seven subtypes. Although JIA imposes a financial burden on society, its full economic impact is yet unknown. Therefore, this study aimed to determine the cost impact of JIA, both from a hospital and a societal perspective, and to investigate differences in costs between JIA subtypes.

METHODS

A cohort of 884 JIA patients (0-18 years), treated in the Wilhelmina Children’s Hospital (the Netherlands), between 04/2011 and 04/2019 was analysed. Data on medication use, imaging, laboratory tests, admissions, operations, consultations, and emergency department visits were collected from the hospital administrative system. These resource use data were multiplied with their unit prices (derived from hospital tariffs, the Dutch Healthcare Authority, the Dutch Pharmacotherapeutic Compass, and the Dutch pediatric formulary) to calculate annual hospital-related costs per patient. Other medical costs (e.g. splints, supplements and general practitioner visits), out-of-pocket costs, and productivity losses were derived from literature to estimate the overall cost impact of JIA to society.

RESULTS

Mean annual hospital-related costs were found to be €5361/patient. The highest annual hospital-related costs (i.e.€13,548/patient) were found in systemic JIA (9.8% of patients), attributable to using biologics as first-line treatment, resulting in mean annual medication costs of €8675/patient, compared with €2583/patient for other JIA subtypes. Based on literature, annual productivity losses were estimated to be €6491/patient, whereas other medical and out-of-pocket costs were estimated at €1711/patient.

CONCLUSIONS

Costs were found to vary substantially between JIA subtypes, with systemic JIA patients having the highest annual hospital-related costs, largely attributable to medication use. When considering the societal perspective, productivity losses were the main cost driver, although evidence in literature was limited and not on the individual patient-level. Thus, to capture the full impact of JIA, future research should also incorporate its (wider) impacts to society.