OBJECTIVES: Rheumatoid arthritis is a chronic and disabling disease associated with considerable global economic burden. The aim of this study was to estimate the economic burden of rheumatoid arthritis and its predictive factors in Saudi Arabia from healthcare provider perspective.

METHODS: This was a retrospective prevalence-based single center cost of illness study conducted at KSUMC. Patients’ medical records were reviewed for the year 2019. A bottom to up micro-costing approach was conducted to estimate the direct medical costs including (medications, lab and diagnostics, hospitalization, procedures, visits, emergency, and physical therapy). Descriptive and inferential statistics were performed.

RESULTS: A total of 400 RA patients included in the study with mean age of 54 years. Most patients (89%) were female and the mean disease duration was 9 year. The average annual cost per patient was estimated as SAR 38,596 ± 3055. The cost increased to SAR 75,097 in patient who had knee replacements procedures. In addition, the cost was significantly increased by SAR 3,971 with each additional comorbidity (p=0.012). The major driver of cost was the cost of biologics followed by lab and diagnostic tests, and outpatient visits (84%, 5%. 3%) respectively. The average annual cost varied by biologic type (SAR 45,360, SAR 33,153) for TNF-inhibitors, and non-TNF inhibitors respectively.

CONCLUSIONS: Rheumatoid arthritis impose a considerable economic burden in Saudi Arabia mainly due the cost of using biologic DMARDs. Decision maker should consider better approaches to lower the cost of using biologics,in addition examining the cost effectiveness of these biologics to determine its value for patients and healthcare system.