Background Rheumatoid Arthritis is chronic inflammatory disease. Early diagnosis and management is necessary to ovoid joint destruction and to minimize disability. It effects 0.5 to 1 percent population. The female to male ratio is 3 to 1. Health care cost is of great concern to patients, physicians and health care policy makers.
The financial impact of rheumatoid arthritis treatment like any chronic illness is of great significance in developing society like Pakistan where 30 percent population lives below poverty line and annual per capita incomes are very low. Whereas prevalence is same with high medicines prices with poorly developed health insurance system and government funded hospitals are scanty.
Most of times attention in the field of health economy is focused on direct medical in general and hospital cost in particular but however there are some social societal customs which also increases the burden of direct cost. The direct cost includes expenditures like physician visit cost, diagnostic tests, medications. There are also some hidden charges to this direct cost which are not included in studies like transport charges, food bills during hospital stay and accompany person, female are companied by males. All included puts strain on economy and major share of annual income of patient is paid on management of disease. The worst scenario is when patient stops treatment and if lucky gets support from other sources like patient welfare societies or from relatives.
Objectives To assess the direct cost of patient's every visit to hospital outpatient department prospectively for one year and total cost of one year was summed up and percentage to annual income spend on treatment was calculated.
Methods Study carried out from January to December 2015 at Fazle Omar Hospital Rabwah Chenab Nagar and 150 patients either newly diagnosed or already on treatment of rheumatoid Arthritis were included. Data collected for next 1 year for each visit, patients with any other disease along with rheumatoid were excluded. The estimated annual income of patient or the person bearing the expenses was recorded before start of study. Every time patient visit hospital outpatient department, prescription copy kept and cost of medicines, laboratory investigations and consultation fee is calculated and a questionnaire is filled how much it cost coming hospital and going back home and during hospital stay on any other things. The total cost of every visit was recorded for one year.
Results The mean total per patient income after conversion from local currency was 3000 US dollars against 1474 US dollars per capita income in 2015. The annual average cost per patient including consultation fee, medicines purchased, laboratory investigations and other overhead expenses like transportation of patient and accompanied person and food bills during hospital stay was 1194 US dollars.
41% of patient gross income was spend on management of rheumatoid arthritis. Investigations cost 12%, medicines purchased 16%, consultation 2% and over head visit charges cost 10% of the total mean of per patient annual income.
Conclusions RA management consumes large portion of patients annual income and it has significant burden on developing world economy.
The economic burden of rheumatoid arthritis in a developing nation: result from one year prospective cohort study in Thailand, Osiri M, Maetzel A, Tugwell P. J Rheumatol 2007 Jan.34(1):57–63.
Disclosure of Interest None declared