Polish archives of internal medicine · 2026
Direct medical costs in inflammatory arthritis: a single-center real-world analysis of cost drivers and impact of a national drug reimbursement program.
СтатьяНазвание и аннотация: Перевод в очереди
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Strach Magdalena, Brkic Alen, Kaczor Marcin, Wójcik Rafał, Kuszmiersz Piotr, Birkenes Tone, Krzanowski Marcin, Topór-Mądry Roman, Haugeberg Glenn, Korkosz Mariusz
Аннотация
INTRODUCTION: The arrival of biologic and targeted synthetic disease‑modifying antirheumatic drugs (b/tsDMARDs) has transformed health care and improved outcomes in patients with rheumatic inflammatory diseases; however, the cost of these therapies remains considerable.
OBJECTIVES: This study aimed to explore direct treatment costs of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA), using real‑world data from a single tertiary center.
PATIENTS AND METHODS: This retrospective study cross‑referenced data from a clinical registry and a health care expenses database covering the period from January 2021 to September 2023. The study included 593 patients with RA (50.6%), PsA (20.3%), and axSpA (29.1%). Direct medical costs were calculated from the public payer and the patient perspectives, encompassing fully reimbursed services and out‑of‑pocket expenses.
RESULTS: The average annual direct medical costs per patient were 4635 EUR for PsA, 3891 EUR for axSpA, and 3106 EUR for RA. The highest health care costs were driven by b/tsDMARDs, which accounted for 94.7% of total costs in PsA, 91.8% in axSpA, and 90.9% in RA. Tumor necrosis factor (TNF) inhibitor use was the highest in axSpA at 61.3% (37.6% biosimilars), whereas for RA it was at 58.3% (41.7% biosimilars), and for PsA at 34.2% (17.5% biosimilars). Anti‑interleukin (IL)-17/IL‑23 agents were used in 42.5% of the PsA and 36.9% of the axSpA patients, while anti‑IL‑6 in 48.7% of the RA patients.
CONCLUSIONS: The direct cost of b/tsDMARDs varied substantially across diseases. Expenditure was the highest in PsA, largely owing to high drug prices and low uptake of biosimilar anti‑TNFs. These findings suggest that an outcome‑oriented strategy favoring more cost‑efficient therapeutic options, where clinically appropriate, may yield meaningful savings.
OBJECTIVES: This study aimed to explore direct treatment costs of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA), using real‑world data from a single tertiary center.
PATIENTS AND METHODS: This retrospective study cross‑referenced data from a clinical registry and a health care expenses database covering the period from January 2021 to September 2023. The study included 593 patients with RA (50.6%), PsA (20.3%), and axSpA (29.1%). Direct medical costs were calculated from the public payer and the patient perspectives, encompassing fully reimbursed services and out‑of‑pocket expenses.
RESULTS: The average annual direct medical costs per patient were 4635 EUR for PsA, 3891 EUR for axSpA, and 3106 EUR for RA. The highest health care costs were driven by b/tsDMARDs, which accounted for 94.7% of total costs in PsA, 91.8% in axSpA, and 90.9% in RA. Tumor necrosis factor (TNF) inhibitor use was the highest in axSpA at 61.3% (37.6% biosimilars), whereas for RA it was at 58.3% (41.7% biosimilars), and for PsA at 34.2% (17.5% biosimilars). Anti‑interleukin (IL)-17/IL‑23 agents were used in 42.5% of the PsA and 36.9% of the axSpA patients, while anti‑IL‑6 in 48.7% of the RA patients.
CONCLUSIONS: The direct cost of b/tsDMARDs varied substantially across diseases. Expenditure was the highest in PsA, largely owing to high drug prices and low uptake of biosimilar anti‑TNFs. These findings suggest that an outcome‑oriented strategy favoring more cost‑efficient therapeutic options, where clinically appropriate, may yield meaningful savings.