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Disease course and healthcare costs of a cohort of rheumatoid arthritis patients from Turkey

  • Observational Research
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Abstract

The objective of the study is to assess the disease course and associated healthcare costs in a cohort of established rheumatoid arthritis (RA) patients in Turkey. The study cohort consisted of 75 RA patients from our outpatient clinic who took part in a previous multicenter study assessing RA-related healthcare costs 6 years ago. In March 2018, we attempted to re-evaluate these patients with the same questionnaire of the previous study enabling us to get information on medication use, comorbidities, and RA-related healthcare costs. We used RAPID-3 for assessing disease activity, HAQ-DI for functional status and EQ-5D for quality of life. Sixty-two (83%) patients were re-evaluated, seven (9.3%) had died and three (4%) were receiving palliative care following major cardiovascular events. Forty-seven (76%) patients had used at least one biologic agent during 79.1 ± 3.3 months after the previous study. At the last evaluation, 34 patients (55%) were on biologics, 22 (35%) were on csDMARDs and 6 (9.6%) were off RA treatment. The mean RAPID3 score (4.3 ± 1.6 SD) was similar to that of the previous study. HAQ-DI (0.69 ± 0.57 SD) and EQ-5D (0.68 ± 0.21 SD) scores showed significant improvement over time. Median direct costs (€2998) were higher than indirect costs (€304). Medication costs were high (€2958). Disease activity remained stable, while functional status and QoL had improved over time. Serious infections and cardiovascular disability are a concern. Medication costs are still the main determinant of RA-related healthcare costs.

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Acknowledgements

Support for the statistical analysis was taken from Omega Contract Research Organization (CRO). We did not receive editing support.

Funding

This study was supported by an unrestricted Grant from Pfizer.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey

    Gizem Ayan

  2. Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey

    Sinem Nihal Esatoglu, Gulen Hatemi & Vedat Hamuryudan

Authors
  1. Gizem Ayan
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  2. Sinem Nihal Esatoglu
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  3. Gulen Hatemi
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  4. Vedat Hamuryudan
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Contributions

All authors made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; and drafted the work or revised it critically for important intellectual content; and approved the final version to be published; and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved and all co-authors take full responsibility for the integrity of the study and the final manuscript.

Corresponding author

Correspondence to Vedat Hamuryudan.

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Conflict of interest

This study was supported by an unrestricted grant from Pfizer. The authors, G. Ayan and S.N. Esatoglu declare no other competing interests. G. Hatemi has received research/grant support, consulting fees and speaker fees from Celgene, speaker fees from Abbvie, UCB pharma and Novartis.V. Hamuryudan has received honoraria and speaker fees from Amgen, MSD, Novartis, Pfizer, Roche UCB and Abbvie.

Ethics approval

This study was conducted in accordance with the Declaration of Helsinki. The ethics committee of Cerrahpasa Medical Faculty of Istanbul University-Cerrahpasa approved the study (89540/07.03.2018).

Consent to participate

Patients having a short-term (< 6 months) appointment gave their written consent at the time of their evaluation in the clinic (n = 52). We posted the consent to ten patients with appointments beyond 6 months after obtaining their verbal consent with a phone call. These patients signed and posted the consent forms back. Ten patients were either deceased or were receiving palliative care. Information on their outcome was obtained from central healthcare system database and from their family members after explaining the aim of the study. Verbal consent was obtained from family members to report their outcome information.

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Not applicable.

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Related congress abstract publication

Disease course and costs of a cohort of rheumatoid arthritis patients over a period of 6 years. Ann Rheum Dis, volume 78, supplement 2, year 2019, page A1577. https://doi.org/10.1136/annrheumdis-2019-eular.984.

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Ayan, G., Esatoglu, S.N., Hatemi, G. et al. Disease course and healthcare costs of a cohort of rheumatoid arthritis patients from Turkey. Rheumatol Int 40, 1037–1044 (2020). https://doi.org/10.1007/s00296-020-04574-9

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  • DOI: https://doi.org/10.1007/s00296-020-04574-9

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