OBJECTIVES Direct non-medical costs may be difficult to assess, so these are often disregarded in cost-of-illness studies. This analysis aims to estimate the annual direct non-medical costs of treating a patient with Rheumatoid Arthritis (AR) in Portugal, per level of disease activity.  METHODS Patients with RA followed by 5 different rheumatologists across the country, were asked to participate in a survey, and informed consent was given by all patients. Besides socio-economic data, the survey included questions regarding the following cost components: number of medical appointments and treatments attended by the patient and its associated travel expenses; expenditures related to adaptations made to their homes and the purchase of medical devices; amount of domiciliary support received, both paid and unpaid. In case of paid domiciliary support patients were also asked about the associated amount. That figure was then used in order to assess the value of unpaid domiciliary support. Disease activity was measured by the DAS28 score.  RESULTS Our final sample consists of 90 patients and descriptive statistics are in line with RA epidemiology (73 women, mean age 56.9). The percentage of patients with low disease activity was 27.7%, whereas, of 43.3% and 28.8% for those with moderate and high disease activity, respectively. Estimated direct non-medical costs ranged from €1,339 to €5,475 per year, for patients with low and high disease activity, respectively. More than 70% of these costs were related to paid and unpaid domiciliary support. CONCLUSIONS Direct non-medical costs are positively associated with disease activity. Estimated costs have a non-negligible magnitude and are entirely borne by patients. Our results confirm the heavy economic burden that RA places on patients and their families.