OBJECTIVES Rheumatoid arthritis (RA) is a chronic, disabling disease with significant impact on patients’ quality of life. Psychological consultation allows to identify factors that might affect patient’s disease activity and adherence. We aimed to describe the cost of psychological consultation in a RA setting, and importance of having a psychological consultation in patients with RA in regards of patient’s treatment benefits and adherence to treatment.

METHODS RA Patients with indication to begin biological therapy or switching from one biological to another is undergoing to a checklist applied with an assessment of the patient’s condition; after this step the patient is presented to a multidisciplinary team meeting and a psychologist is assessing the particular case of the patient doing recommendations regarding the patient’s treatment. We calculated the costs pf psychology consultation and possible economic impact on treatment.

RESULTS During 2018 our psychologist evaluated 655 patients, 83% were female and 17% male, mean age was 60 years ± 11. From all patients 97% were evaluated before initiation of biological therapy; and 3% for changes in biological therapy. The psychologist assessed factors such as adherence, psychosocial support and patient cooperation. After the assessment, psychologist suggested to the multidisciplinary team in 50% of cases to wait and evaluate carefully the patient before starting biological therapy, 40% of cases patients were assessed as suitable for biological therapy, 10% of cases patients were referred to other medical specialties before starting biological therapy. Regarding costs, psychological consultation for all patients costed $8,922.79 USD, and the avoidance of prescribing biological therapy in 50% of patients saved in average $3,238,900.21 USD/year.

CONCLUSIONS Inclusion of a psychologist as an active participant in the decision making for treating patient with RA, is a low-cost intervention that approaches the patient from many perspectives that influence adherence to a therapy.