title: The cost of care of rheumatoid arthritis and ankylosing spondylitis patients in tertiary care rheumatology units in Turkey.
abstract: OBJECTIVE
  To determine the direct and indirect costs due to rheumatoid arthritis (RA) and ankylosing spondylitis (AS) patients in Turkey.
  
  
  METHODS
  An expert panel was convened to estimate the direct and indirect costs of care of patients with RA and AS in Turkey. The panel was composed of 22 experts chosen from all national tertiary care rheumatology units (n=53). To calculate direct costs, the medical management of RA and AS patients was estimated using 'cost-of-illness' methodology. To measure indirect costs, the number of days of sick leave, the extent of disability, and the levels of early retirement and early death were also evaluated. Lost productivity costs were calculated using the 'human capital approach', based on the minimum wage.
  
  
  RESULTS
  The total annual direct costs were 2,917.03 Euros per RA patient and 3,565.9 Euros for each AS patient. The direct costs were thus substantial, but the indirect costs were much higher because of extensive morbidity and mortality rates. The total annual indirect costs were 7,058.99 Euros per RA patient and 6,989.81 for each AS patient. Thus, the total cost for each RA patient was 9,976.01 Euros and that for an AS patient 10,555.72 Euros, in Turkey.
  
  
  CONCLUSIONS
  From the societal perspective, both RA and AS have become burden in Turkey. The cost of lost productivity is higher than the medical cost. Another important conclusion is that indirect costs constitute 70% and 66% of total costs in patients with RA and AS, respectively.
authors.affiliation: Baskent University Faculty of Health Sciences, Ankara, Turkey. bmalhan@baskent.edu.tr
authors.forename: Simten
authors.initials: S
authors.lastname: Malhan
authors.forename: Salih
authors.initials: S
authors.lastname: Pay
authors.forename: Sebnem
authors.initials: S
authors.lastname: Ataman
authors.forename: Ediz
authors.initials: E
authors.lastname: Dalkilic
authors.forename: Ayhan
authors.initials: A
authors.lastname: Dinc
authors.forename: Eren
authors.initials: E
authors.lastname: Erken
authors.forename: Ihsan
authors.initials: I
authors.lastname: Ertenli
authors.forename: Esin
authors.initials: E
authors.lastname: Ertugrul
authors.forename: Feride
authors.initials: F
authors.lastname: Gogus
authors.forename: Vedat
authors.initials: V
authors.lastname: Hamuryudan
authors.forename: Murat
authors.initials: M
authors.lastname: Inanc
authors.forename: Yasar
authors.initials: Y
authors.lastname: Karaarslan
authors.forename: Omer
authors.initials: O
authors.lastname: Karadag
authors.forename: Yuksel
authors.initials: Y
authors.lastname: Karakoc
authors.forename: Goksal
authors.initials: G
authors.lastname: Keskin
authors.forename: Bunyamin
authors.initials: B
authors.lastname: Kisacik
authors.forename: Sedat
authors.initials: S
authors.lastname: Kiraz
authors.forename: Fahrettin
authors.initials: F
authors.lastname: Oksel
authors.forename: Ergun
authors.initials: E
authors.lastname: Oksuz
authors.forename: Timur
authors.initials: T
authors.lastname: Pirildar
authors.forename: Ismail
authors.initials: I
authors.lastname: Sari
authors.forename: Mehmet
authors.initials: M
authors.lastname: Soy
authors.forename: Taskin
authors.initials: T
authors.lastname: Senturk
authors.forename: Ali
authors.initials: A
authors.lastname: Taylan
mesh_terms: D000041:Absenteeism; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis / Q000191:economics* / Q000401:mortality / Q000628:therapy; D017281:Cost of Illness; D004185:Disability Evaluation; D017721:Hospital Costs; D006757:Hospital Units / Q000191:economics*; D006801:Humans; D018803:Models, Economic; D011379:Prognosis; D012179:Retirement / Q000191:economics; D012219:Rheumatology / Q000191:economics*; D018582:Sick Leave / Q000191:economics; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000175:diagnosis / Q000191:economics* / Q000401:mortality / Q000628:therapy; D014421:Turkey