Disease course and healthcare costs of a cohort of rheumatoid arthritis patients from Turkey

Abstract

The objective of the study is to assess the disease course and associated healthcare costs in a cohort of established rheumatoid arthritis (RA) patients in Turkey. The study cohort consisted of 75 RA patients from our outpatient clinic who took part in a previous multicenter study assessing RA-related healthcare costs 6 years ago. In March 2018, we attempted to re-evaluate these patients with the same questionnaire of the previous study enabling us to get information on medication use, comorbidities, and RA-related healthcare costs. We used RAPID-3 for assessing disease activity, HAQ-DI for functional status and EQ-5D for quality of life. Sixty-two (83%) patients were re-evaluated, seven (9.3%) had died and three (4%) were receiving palliative care following major cardiovascular events. Forty-seven (76%) patients had used at least one biologic agent during 79.1 +/- 3.3 months after the previous study. At the last evaluation, 34 patients (55%) were on biologics, 22 (35%) were on csDMARDs and 6 (9.6%) were off RA treatment. The mean RAPID3 score (4.3 +/- 1.6 SD) was similar to that of the previous study. HAQ-DI (0.69 +/- 0.57 SD) and EQ-5D (0.68 +/- 0.21 SD) scores showed significant improvement over time. Median direct costs (euro2998) were higher than indirect costs (euro304). Medication costs were high (euro2958). Disease activity remained stable, while functional status and QoL had improved over time. Serious infections and cardiovascular disability are a concern. Medication costs are still the main determinant of RA-related healthcare costs.