title: Societal costs of rheumatoid arthritis in China: a hospital-based cross-sectional study.
abstract: OBJECTIVE
  To estimate the annual direct and indirect costs of rheumatoid arthritis (RA) in China and identify the predictors for cost of illness.
  
  
  METHODS
  A cross-sectional study of cost of illness from the societal perspective was conducted on 829 patients with RA in 21 tertiary care hospitals in China between July 2009 and December 2010. Data on demographics, clinical variables, and components of costs were collected by physician interview. Costs were represented in 2009 US dollars using purchasing power parity estimates. Univariate and multivariate linear regression analyses were performed to identify the predictors for cost of illness.
  
  
  RESULTS
  The mean ± SD total cost of RA in China was $3,826 ± $5,659 per patient-year, given a gross domestic product per capita of $6,798 in China in 2009. Direct costs and indirect costs comprised 90.0% and 10.0% of the total costs, respectively. Drug expense represented approximately half of the total costs, dominated by biologic agents (48.2%) and disease-modifying antirheumatic drugs (23.5%). Additionally, the cost of extracted herbal drugs and traditional Chinese medicine comprised ∼17.6% of the drug expense. Higher education level, noninsured status, longer disease duration, more extraarticular manifestations, and higher Health Assessment Questionnaire score independently predicted higher total costs.
  
  
  CONCLUSIONS
  Our results provide the first study of costs of RA in China. This study not only demonstrates the economic burden of RA, but also identifies the predictors that could be interventional factors to reduce the societal costs of RA in China.
authors.affiliation: People's Hospital, Peking University Health Science Center, Beijing, China.
authors.forename: Chuanhui
authors.initials: C
authors.lastname: Xu
authors.forename: Xiuru
authors.initials: X
authors.lastname: Wang
authors.forename: Rong
authors.initials: R
authors.lastname: Mu
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.forename: Ye
authors.initials: Y
authors.lastname: Zhang
authors.forename: Shuling
authors.initials: S
authors.lastname: Han
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Li
authors.forename: Yongfu
authors.initials: Y
authors.lastname: Wang
authors.forename: Guochun
authors.initials: G
authors.lastname: Wang
authors.forename: Ping
authors.initials: P
authors.lastname: Zhu
authors.forename: Hongtao
authors.initials: H
authors.lastname: Jin
authors.forename: Lin
authors.initials: L
authors.lastname: Sun
authors.forename: Haiying
authors.initials: H
authors.lastname: Chen
authors.forename: Liufu
authors.initials: L
authors.lastname: Cui
authors.forename: Zhuoli
authors.initials: Z
authors.lastname: Zhang
authors.forename: Zhenbin
authors.initials: Z
authors.lastname: Li
authors.forename: Junfang
authors.initials: J
authors.lastname: Li
authors.forename: Fengxiao
authors.initials: F
authors.lastname: Zhang
authors.forename: Jinying
authors.initials: J
authors.lastname: Lin
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Liu
authors.forename: Shaoxian
authors.initials: S
authors.lastname: Hu
authors.forename: Xiuyan
authors.initials: X
authors.lastname: Yang
authors.forename: Bei
authors.initials: B
authors.lastname: Lai
authors.forename: Xingfu
authors.initials: X
authors.lastname: Li
authors.forename: Xiaoyuan
authors.initials: X
authors.lastname: Wang
authors.forename: Yin
authors.initials: Y
authors.lastname: Su
authors.forename: Zhanguo
authors.initials: Z
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000191:economics*; D002681:China; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062606:Tertiary Care Centers / Q000706:statistics & numerical data
chemical_list: D018501:Antirheumatic Agents