Healthcare Attributable Costs of Rheumatoid Arthritis in Colombia: A Real-World Study Based on National Contributory Scheme Claims Data.

OBJECTIVES

This study aims to estimate the economic burden of rheumatoid arthritis (RA) in Colombia, evaluating total healthcare expenditures and, specifically, costs directly associated with the disease.

METHODS

We conducted a retrospective analysis using nationwide administrative data from Colombia's contributory healthcare scheme for 2018. RA patients were identified through an electronic algorithm based on ICD-10 diagnostic codes and medications. Analyzed costs encompassed direct medical expenditures, including medications, outpatient consultations, diagnostic tests, procedures, and hospitalizations. Marginal costs attributable to RA were estimated using a methodology based on attributable risks using propensity score matching. Expenditures were compared with 2 matched control groups without RA, adjusted for demographic and clinical characteristics.

RESULTS

The total national economic burden of RA in Colombia, reported in US$2018 purchasing power parity, was estimated at $1069 million, with $566 million attributed explicitly to directly associated excess healthcare expenditures. The average annual cost per RA patient was $3422 (± $7573), whereas directly attributable RA costs per patient were $1756 (95% CI: 1703-1809). Medication expenses represented the largest share, accounting for 53.2% of total RA-related costs, averaging $1483 per RA patient, significantly higher than the non-RA comparison groups ($260 and $163, respectively). Biological disease-modifying antirheumatic drugs alone accounted for 65.0% of medication costs. Outpatient services represented 71.6% of total expenditures, followed by hospitalizations at 19.2%.

CONCLUSIONS

RA presents a considerable economic burden in Colombia, driven primarily by medication, especially biologics and outpatient services. Strategies aiming at the cost-effective management of RA treatments could alleviate the associated healthcare expenditures.