OBJECTIVES Assess RA health care resource utilization in a sample of Brazilian private health system beneficiaries. METHODS Three Health Management Organization (HMOs) databases were analyzed retrospectively, involving 1,057,033 people, corresponding to approximately 3% of total private health system beneficiaries in Brazil. The analysis was done in 35 months (from January 2004 to November 2007). The following health care resources were considered: clinical appointment, hospitalization, emergency service, drugs and laboratory exams. All RA patients were compared to non-RA patients in terms of health care resource usage. RESULTS From 1,057,033 people analyzed, 4,817 (0.46%) were classified as having RA, being the prevalence rate among women and men 3.5: 1. Those patients concentrated 4.8% of the total costs of whole population analyzed. The cost per month/per member (cost pm/pm) of RA patients was 6.6 times higher than non-RA population. In addition, RA patients, compared to non-RA patients, demonstrated 3.4 and 13 times higher clinical appointments and hospitalization, respectively. Considering other chronic diseases (hypertension, heart failure, asthma, bronchitis and diabetes mellitus patients), RA patients demonstrated 1.4 and 3.1 times higher clinical appointments and hospitalization, respectively. Comorbiditidy was associated to 33% of RA patients, mainly cardiovascular disorders (CVD). CONCLUSIONS Our results reinforce the international literature data demonstrating that despite 0.46% prevalence, RA has high individual cost (concentrating 4.8% of total costs of whole population analyzed) due to multifactor variables, including pharmaceutical assistance and comorbidities. Regarding healthcare resources the study showed that RA patients had a higher utilization than non- RA patients, confirming the literature about the important cost of the disease in the clinical practice. In addition we suggest an important association between RA and comorbidities, especially CVD. In conclusion, RA may require specific strategies by decision makers to optimize its management and reduce cost