title: Medical care costs of patients with rheumatoid arthritis during the prebiologics period in Japan: a large prospective observational cohort study.
abstract: Our objective was to describe outpatient medical care costs of patients with rheumatoid arthritis (RA) in the prebiologics period in Japan. The outpatient costs of 6,771 RA patients (17,666 patient years) who were enrolled in an observational cohort study at the Institute of Rheumatology, Rheumatoid Arthritis (IORRA), in Tokyo, Japan, were calculated from the billing records dated from 2000 to 2004. Associations between outpatient costs and variables such as age, RA duration, RA disease activities, and disability levels were assessed. The average outpatient cost gradually increased (+7.7% in 4 years) from 271,498 JPY per year in 2000 to 292,417 JPY per year in 2004. Medications accounted for approximately 50% of total outpatient costs, which increased 29.6% during the 4 years. The outpatient costs increased in association with aging, longer RA duration, higher Disease Activity Score of 28 Joints (DAS28), and higher Japanese version of Health Assessment Questionnaire (J-HAQ) score. Generalized linear regression analysis revealed that both DAS28 and J-HAQ scores were the most significant factors associated with outpatient costs (p < 0.001). Outpatient costs for patients with RA increased year after year over the 4-year period under observation in Japan. Medical costs were higher with increasing RA disease activity and disability levels.
authors.affiliation: Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA. e-tanaka@tkg.att.ne.jp
authors.forename: Eiichi
authors.initials: E
authors.lastname: Tanaka
authors.forename: Eisuke
authors.initials: E
authors.lastname: Inoue
authors.forename: Ajitha
authors.initials: A
authors.lastname: Mannalithara
authors.forename: Mihoko
authors.initials: M
authors.lastname: Bennett
authors.forename: Shigeo
authors.initials: S
authors.lastname: Kamitsuji
authors.forename: Atsuo
authors.initials: A
authors.lastname: Taniguchi
authors.forename: Shigeki
authors.initials: S
authors.lastname: Momohara
authors.forename: Masako
authors.initials: M
authors.lastname: Hara
authors.forename: Gurkirpal
authors.initials: G
authors.lastname: Singh
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yamanaka
mesh_terms: D000553:Ambulatory Care / Q000191:economics*; D018501:Antirheumatic Agents / Q000191:economics / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000191:economics* / Q000503:physiopathology; D001688:Biological Products / Q000627:therapeutic use; D004185:Disability Evaluation; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data* / Q000639:trends; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products