title: Healthcare service utilisation costs attributable to rheumatoid arthritis in France: Analysis of a representative national claims database.
abstract: OBJECTIVE
  To estimate healthcare service utilisation costs of patients with rheumatoid arthritis in France and to estimate the fraction of these costs attributable to RA.
  
  
  METHODS
  The "Échantillon généraliste des bénéficiaires" (EGB) is a 1/97 random sample of the main national claims database covering the French population. A cohort of patients with rheumatoid arthritis was constituted of all adults benefiting from full coverage for rheumatoid arthritis (ICD-10 M05-06) on 1st january 2009. A control group matched for age and gender was identified. Health expenditures were assessed from the payer's perspective for the year 2010.
  
  
  RESULTS
  The annual per capita reimbursed total health expenditure was €6,404 in 2010, an amount around two times higher than in the control group €3,095 (P<0.0001). The main contributors to this extra cost were outpatient care (+€2,407; 72.7%), including medication (+€1,686; 50.0%), and inpatient care (+€903; 27.3%). Patients treated by biological agents generated an age-adjusted per capita annual expenditure about three times higher than untreated patients (€15,757 versus €4,640).
  
  
  CONCLUSIONS
  Only half of medical expenditure by patients with rheumatoid arthritis is attributable to their disease and use of biological agents has become a major driver of cost.
authors.affiliation: UPMC-GRC 08, institut Pierre-Louis d'épidémiologie et Santé publique, 75252 Paris cedex 05, France; Service de rhumatologie, groupe hospitalier Pitié-Salpêtrière, AP-HP, 83, boulevard de l'Hôpital, 75013 Paris, France. Electronic address: bruno.fautrel@psl.aphp.fr.
authors.forename: Bruno
authors.initials: B
authors.lastname: Fautrel
authors.affiliation: UCB Pharma, 92700 Colombes, France.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Cukierman
authors.affiliation: UCB Pharma, 92700 Colombes, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Joubert
authors.affiliation: Cemka-Eval, 92340 Bourg-la-Reine, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Laurendeau
authors.affiliation: Inserm U1018 - UVSQ, 94807 Villejuif, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Gourmelen
authors.affiliation: Cemka-Eval, 92340 Bourg-la-Reine, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Fagnani
mesh_terms: D001172:Arthritis, Rheumatoid / Q000191:economics* / Q000453:epidemiology; D016208:Databases, Factual; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data*; D005602:France / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D009313:National Health Programs / Q000191:economics* / Q000706:statistics & numerical data
keywords: Biological agents; Cost; France; Rheumatoid arthritis