 |
|
|
 |
The Economic Burden of Rheumatoid Arthritis in a Developing Nation: Results from a One-Year Prospective Cohort Study in Thailand
MANATHIP OSIRI, ANDREAS MAETZEL, and PETER TUGWELL ABSTRACT. Objective. To assess annual direct and indirect costs in a prospective cohort of patients with rheumatoid arthritis (RA) in Thailand from the societal perspective. Methods. Data on costs and intangible losses were prospectively collected at regular intervals over a one-year period from 158 RA patients who attended a major tertiary care facility in Bangkok, Thailand. Direct medical, direct nonmedical, indirect, and total costs were estimated according to patients' respective health insurance conditions and converted to 2001 US dollars using published purchasing power parity estimates. Sensitivity analyses were performed and the predictors of costs and intangible losses were investigated. Results. The average societal cost of RA was estimated to be US$2682, 41.4% of patients' average annual income. Average direct and indirect costs were estimated to amount to US$2135 and US$547 per patient per year, respectively. Seventy-three patients (46.2%) experienced at least one event of intangible losses and 46 patients (29.1%) had decreased earnings ability because of RA. Poor physical function, joint deformity, high number of disease modifying antirheumatic drugs, and steroid use contributed to higher costs and presence of intangible losses. Conclusion. RA consumes a significant proportion of patients' annual average incomes and poses a significant economic burden to society. Since RA mainly affects a working-age population, early and timely treatment of this disease can improve both the suffering and the economic productivity of patients in Thailand. (First Release Dec 15 2006; J Rheumatol 2006;34:57–63) Key Indexing Terms:
COST ANALYSIS From the Division of Rheumatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Supported by the Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University. M. Osiri, MD, Associate Professor, Division of Rheumatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; A. Maetzel, MD, MSc, PhD, Assistant Professor, Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada, and Amgen Inc., Department of Global Health Economics and Outcomes Research, Zug, Switzerland; P. Tugwell, MD, MSc, FRCPC, Professor of Medicine and Epidemiology and Community Medicine, University of Ottawa, and Director, Centre for Global Health, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada. Address reprint requests to Dr. M. Osiri, Division of Rheumatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok, 10330, Thailand. E-mail: Manathip.O@chula.ac.th Accepted for publication September 25, 2006. |
