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Arch Hellen Med, 25(2), March-April 2008, 231-243


Measuring the cost of rheumatoid arthritis: Methodological issues and international practice

Department of Government and Public Affairs, Wyeth Hellas SA, Athens, Greece

The purpose of this review of the international literature is to highlight the most important methodological issues that arise when designing a cost study for rheumatoid arthritis. Rheumatoid arthritis is a chronic disease that poses a significant burden on the quality of life of patients and results in high costs for the healthcare system. Relevant studies have shown that the costs of the disease rise significantly as the functional ability of the patient declines. Moreover, the introduction of new biological drugs can considerably increase the cost of treating the disease, although they have been shown to delay joint damage significantly. Thus, it is especially important to measure the cost of the disease accurately and to determine the factors that affect it. The cost-of-illness studies for rheumatoid arthritis reported to date present varying estimates, the differences in which are largely attributed to methodological variations. The findings of this review suggest that the most significant methodological problems concern the choice of the cost categories to be measured, the choice of method for the collection of resource utilization data, and the methodology for calculating indirect costs. Review of the relevant literature results in the following suggestions: the cost categories should include medication, medical visits, hospital admissions and surgical procedures. Collecting resource utilization from patients with the use of appropriate questionnaires can be a reliable method, especially when no suitable databases are available; indirect costs comprise a significant part of the total cost, and patient questionnaires can provide reliable information regarding productivity losses.

Key words: Cost, Methodology, Rheumatoid arthritis.

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