OBJECTIVES: To estimate risk-adjusted healthcare costs and identify associated risk factors for rheumatoid arthritis (RA) expenditures in Turkey using real-world data. METHODS: This study used research-identified data from a system that processes claims for all Turkish health insurance funds. Incident cases of adult RA patients with two RA visits at least 60 days apart, identified between June 1, 2010 and December 31, 2010, were required to have no RA diagnosis before June 1, 2010, with at least 1 year of continuous enrollment forthe baseline and follow-up years. Pharmacy, outpatient and inpatient claims were compiled over the study period for theselected patients. RESULTS: Among 693 patients (mean age: 52.08; female: 80%), 19.6% were age 18-39, 60.9% were 40-64 years and 19.5% were age 65 or older. RA diagnosis was most prevalent in the Marmara region (44%), followed by Central Anatolia (23%), Aegean (16%), and Mediterranean (11%).  Nearly 35%of RA patients had at least one cardiovascular, diabetic, respiratory or allergy comorbid condition prior to diagnosis. Most patients were prescribed non-COX inhibitors (79%) and immunosuppressants (43%), and 4% of patients were prescribed disease-modifying anti-rheumatic drugs (DMARDs). The total annual cost (ª2,000) was comprised of mainly pharmacy (ª1,201), followed by outpatient (ª411), and inpatient costs (ª361),and an average copay of ª27. Prior comorbid conditions including diabetes, respiratory disease as well as hospitalization, glucocorticoid and DMARD use significantly contributed to annual healthcare costs, unlike gender and age. CONCLUSIONS: Annual costs of RA patients are significantly lower in Turkey relative to other countries in Europe, yet, pharmaceutical expenditures cover a significant portion of the overall cost. Comparative effectiveness studies are needed to further decrease pharmaceutical expenditures for RA treatment.