title: Direct costs of medical attention to Mexican patients with rheumatoid arthritis in a tertiary care center.
abstract: OBJECTIVE
  Rheumatoid arthritis (RA) is a disease that often requires multiple drug treatment for long periods of time. The purpose of this study was to assess the direct costs of medical care for RA patients seen in a tertiary care center in Mexico City.
  
  
  METHODS
  The clinical cases of 3 patients attending our Institution were studied. These represented: (i) one with a disease easily controlled with a disease modifying anti-rheumatic drug (DMARD) (mild disease), (ii) one adequately controlled with 2 or more DMARDs (moderate disease), and (iii) one poorly controlled in spite of multiple DMARDs (severe disease). The costs of the medical visits and of all laboratory and routine examinations during the last year were estimated according to local tabulators, considering the options of highest, intermediate and lowest costs. The costs of the prescribed medications were calculated from current price lists obtained from four drugstores near the Institution.
  
  
  RESULTS
  Medical care to an RA patient costs between US $19 and US $221.70 monthly (US $228.08 and US $2,661.40 per year) depending on the socio-economic status of the patient and on variables related to the activity and severity of the disease in our setting. The number of medical visits represented 0.1% to 12.7% of the total costs, laboratory and routine examinations 0.1% to 7.1%, and medications 81.8% to 99.8%. For reference the minimum wage in Mexico is US $90.40 per month.
  
  
  CONCLUSIONS
  The direct costs of medical care to RA patients in our setting can be high, and greatly depends on the prescribed medications.
authors.affiliation: Department of Immunology and Rheumatology, Instituto Nacional de la Nutrición Salvador Zubirán, México DF, México.
authors.forename: R
authors.initials: R
authors.lastname: Ariza-Ariza
authors.forename: M
authors.initials: M
authors.lastname: Mestanza-Peralta
authors.forename: M H
authors.initials: MH
authors.lastname: Cardiel
mesh_terms: D018501:Antirheumatic Agents / Q000191:economics / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D004180:Direct Service Costs; D016527:Drug Costs; D006403:Hematologic Tests / Q000191:economics; D006801:Humans; D008800:Mexico; D009819:Office Visits / Q000191:economics
chemical_list: D018501:Antirheumatic Agents