Indirect costs of rheumatoid arthritis in Brazil.
OBJECTIVE
The present study aimed to determine indirect costs of rheumatoid arthritis (RA) in a sample of patients followed at a public health-care facility in Brazil. Factors potentially associated with higher indirect costs in these patients were also investigated.


METHODS
This cross-sectional study included patients between 18 and 65 years old with RA according to the American College of Rheumatology criteria. Patients who were working, on sick leave or retired early due to RA were invited to participate in the survey. A systematic structured interview was conducted in all patients including demographic, socioeconomic, and clinical variables and an experienced rheumatologist examined all patients. Estimates of the indirect costs in the preceding 12 months were performed using the human-capital approach based on the society perspective. Multiple linear regression models were used to determine the variables associated with higher indirect costs.


RESULTS
A total of 192 patients were included in the study. Forty-seven of them (24.5%) had retired early due to RA, 62 others (32.3%) were on sick leave due to RA while 83 patients (43.2%) were working at the time of the interview. Estimated indirect cost for this population was US$ 466,107.81 or US$ 2,423.51 per patient per year. Factors associated with higher costs were RA poor functional class, high socioeconomic status and male patients (p < 0.001).


CONCLUSIONS
Estimated costs found in our population are similar to that described in more developed countries. Indirect costs were higher in patients with poor functional classes, high socioeconomic status, and men.
de Azevedo
Ana Beatriz Cordeiro
AB
Rheumatology Division, Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil. anabiazevedo@hotmail.com
Ferraz
Marcos Bosi
MB
Ciconelli
Rozana Mesquita
RM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D018501:Antirheumatic Agents / Q000191:economics* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004526:Efficiency; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D015233:Models, Statistical; D015999:Multivariate Analysis; D010147:Pain Measurement; D019057:Quality-Adjusted Life Years; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D055815:Young Adult
D018501:Antirheumatic Agents