OBJECTIVES

We aimed to estimate the direct medical costs for an average patient with moderate-severe disease activity of rheumatoid arthritis (RA) in the first year of treatment in Colombia.

METHODS

A cost description study for an average patient with moderate-severe disease activity of RA was performed. Costs were analyzed from the third payer perspective. Average direct medical costs were estimated by cost items (pharmacological treatment, diagnosis process and consultations). The treatment dosage for RA was based on RA guidelines. Standard use of health services to treat RA was costed using the recommendations of the Institute of Technological Evaluation in Health of Colombia. Costs of drugs were estimated from the Circulars of the National Commission of prices of medicines and medical devices, and from SISMED, official source of medication prices. Costs of medical procedures were calculated from ISS 2001 +30% (national official tariff). Costs were reported using means and minimum and maximum values in Colombian pesos, 2018.

RESULTS

Treating a patient with moderate-severe RA for a year costs on average COP$14,696,300 (13,900,479-15,695,327). This cost is mainly explained by the pharmacological treatment with biological therapy, which is COP$11,419,542 (10,728,933-11,962,479) and represents 77.8% of the total direct medical cost. The treatment with combined therapy costs per year on average COP$1,601,275 (1,561,833-1,817,994), and represents 10.9%, and with monotherapy it costs COP$1,260,562 (1,260,000-1,285,189). Outpatient consultations cost COP$86,840 (86,840-86,840) and lab tests COP$142,474 (142,473-142,473), meaning the remaining 11.3% of the cost for a moderate-severe RA standard treatment per year.

CONCLUSIONS

In 2017 there were reported to the Colombian administrative registry of RA 12,076 moderate-severe cases of RA. If the moderate-severe RA cost per year estimated in this study is extrapolated to the entire country, we estimate that these patients may cost COP$177,472,518,800 per year, representing an important economic burden to the Colombian health system.