title: Costs of rheumatoid arthritis during the period 1990-2010: a register-based cost-of-illness study in Sweden.
abstract: OBJECTIVE
  The objectives of this study were to analyse the total socio-economic impact of RA in Sweden during the period 1990-2010 and to analyse possible changes in costs during this period. The period was deliberately chosen to cover 10 years before and 10 years after the introduction of biologic drugs.
  
  
  METHODS
  A prevalence-based cost-of-illness study was conducted based on data from national and regional registries.
  
  
  RESULTS
  There was a decrease in the utilization of RA-related inpatient care as well as sick leave and disability pension during 1990-2010 in Sweden. Total costs for RA are presented in current prices as well as inflation-adjusted with the consumer price index (CPI) and a healthcare price index. The total fixed cost of RA was €454 million in 1990, adjusted to the price level of 2010 with the CPI. This cost increased to €600 million in 2010 and the increase was mainly due to the substantially increasing costs for pharmaceuticals. Of the total costs, drug costs increased from 3% to 33% between 1990 and 2010. Consequently the portion of total costs accounting for indirect costs for RA is lowered from 75% in 1990 to 58% in 2010.
  
  
  CONCLUSIONS
  By inflation adjusting with the CPI, which is reasonable from a societal perspective, there was a 32% increase in the total fixed cost of RA between 1990 and 2010. This suggests that decreased hospitalization and indirect costs have not fallen enough to offset the increasing cost of drug treatment.
authors.affiliation: Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, SE-581 83 Linköping, Sweden. almina.kalkan@liu.se.
authors.forename: Almina
authors.initials: A
authors.lastname: Kalkan
authors.forename: Eva
authors.initials: E
authors.lastname: Hallert
authors.forename: Lars
authors.initials: L
authors.lastname: Bernfort
authors.forename: Magnus
authors.initials: M
authors.lastname: Husberg
authors.forename: Per
authors.initials: P
authors.lastname: Carlsson
mesh_terms: D018501:Antirheumatic Agents / Q000191:economics* / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000191:economics*; D017281:Cost of Illness; D016527:Drug Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D018803:Models, Economic; D012042:Registries; D012189:Retrospective Studies; D018582:Sick Leave / Q000191:economics; D013548:Sweden
chemical_list: D018501:Antirheumatic Agents
keywords: biologic drugs; cost of illness; longitudinal; rheumatoid arthritis; socioeconomic