Background There is a lack of expertise in the rheumatoid arthritis (RA) diagnosis in primary level medical centers in Colombia. Frequently, patients with osteoarthritis (OA) are misdiagnosed as rheumatoid arthritis (RA) in primary care centers, leading to wrong treatment and consequent clinical and pharmacoeconomic impact, because there are an important number of those patients with OA misdiagnosed as RA treated as such with disease modifying anti-rheumatic drugs (DMARDs), leading to higher economic costs for health system.
Objectives The aim of this study was to calculate costs of the OA patients misdiagnosed as RA in a 24 month period in a cohort of patients derived to a specialized RA center in Colombia.
Methods A descriptive cross sectional study was performed. Patients derived during a 24 month period to a RA specialized center with presumptive diagnosis of this disease and found finally diagnosed with OA were included in analysis. We described the direct costs in US dollars (USD) of their care assuming an average of 4 visits/year to general practitioner ($4 USD/consultation), 2 visits/year for physiatrist and orthopedics ($17.33 USD/consultation) and 4 set/year of conventional laboratories ($46.14 USD/set). Cost of medication doses were calculated for an average use of methotrexate, sulfasalazine, chloroquine and prednisolone ($ 120.96 USD/monthly). Indirect costs were not calculated.
Results We found 1116 OA patients misdiagnosed as RA in a period of 24 months. For each patient we calculated $16 USD/year for general practitioner visits, $34.7 USD/year for specialized medicine visits, $184.6 USD/year for laboratory sets and $1.451 USD/year for medications. This leads to a total cost of $1.686.8 USD/year per patient. From a total of 1116 misdiagnosed patients the cost rises to $1'882.468.8 USD/year. These patients had an average of 4.5 years of wrong treatment for their misdiagnosis, making the cost rise up to $8'471.106 million US dollars.
Conclusions There is an important economic implication of the misdiagnosis of OA as RA, being this the most frequent mistake in the diagnosis of this disease. The implementation of educational programs for health care primary physicians and specialized RA centers could save this amount of money for the health system in Colombia.
Disclosure of Interest None declared