OBJECTIVES: The aim of this study is to identify factors associated with the cost of RA care and calculated risk-adjusted costs associated with RA in Turkey. The relationships between costs of RA treatment and disease activity was also examined. METHODS: This cross-sectional study was performed in 10 tertiary rheumatology centers. Eligible patients were ≥18 years of age diagnosed as having RA for at least 12 months according to the American College of Rheumatology (ACR) 1987 criteria. Overall costs were categorized as inpatient, outpatient and pharmacy costs. Generalized linear models were used to calculate risk-adjusted direct costs. RESULTS: A total of 698 patients were studied. Patients’ visual analog scale (VAS), patient’s global disease activity (GDA) and routine assessment of patient index data 3 (RAPID-3) scores were on average 44.15, 5.19 and 5.10 respectively. Most patients were prescribed immunosuppressive medications and glucorticoids (87.8% and 61.2%, respectively). After adjusting all variables, total annual medical cost was €2,671. The most significant portion of overall expenditures was due to pharmaceutical costs €1,987, while outpatient costs were €303, inpatient costs were €360 and co-payments were €21. 14% of patients experienced work loss due to RA. On average, annual costs due to workday loss were €480. 5.4% of patients also had other RA-related consultations, which were not covered by insurance, bringing the average annual burden to €1,600 for these patients. 6.5% of RA patients had additional costs related to their condition such as the need for a new car, apartment or special equipment, spending an additional €1,640 in 1 year. 13.7% of patients required caregivers. The average annual out-of-pocket amount paid to caregivers was €624. CONCLUSIONS: The annual medical cost of RA in Turkey, although significantly lower compared to European estimates, causes considerable economic burden. Drug costs constitute the major part of annual cost for RA followed by indirect costs.