Healthcare consumption and direct costs of rheumatoid arthritis in Belgium

Abstract

The aim of this study was to compare the socioeconomic consequences of early and late rheumatoid arthritis in Belgium and to assess the patient out-of-pocket contributions. This multicentre longitudinal study in Belgium evaluated patients with rheumatoid arthritis. Early disease was defined as diagnosis since less than 1 year. At baseline sociodemographic and disease characteristics were assessed and during the following year patients recorded all healthcare- and non-healthcare-related direct costs and out-of-pocket contributions. The study included 48 patients with early and 85 patients with late rheumatoid arthritis. Mean disease duration was 0.5 vs 12.5 years in patients with early and late rheumatoid arthritis, respectively. The disease activity score (DAS28) was comparable between both groups (4.1 vs 4.5, p = 0.14), but physical function (Health Assessment Questionnaire, HAQ) was more impaired in patients with long-standing disease (1.0 vs 1.7, p < 0.001). Work disability had increased from 2% in patients with early to 18% in patients with late disease. The annual societal direct costs per patient were 3055 Euros (median: 1518 Euros) opposed to 9946 Euros (median: 4017 Euros) for early and late rheumatoid arthritis, respectively. The higher direct cost for patients with long-standing disease was seen for all categories, but especially for physiotherapy and need for devices and adaptations. Patients with early as well as late disease contribute out of pocket about one-third to the direct healthcare costs. Within each group, HAQ was a strong determinant of costs. In Belgium, patients with long-standing rheumatoid arthritis are nine times more likely to be work disabled than patients with less than 1 year disease duration and have a threefold increase in costs. Differences in healthcare consumption between patients could be mainly explained by differences in physical function (HAQ).

Access to biologic treatment for rheumatoid arthritis in Central and Eastern European (CEE) countries

“…In Belgium, direct costs reported for late RA (disease duration 12.5 yrs) were even higher – 9,946 Euro/patient/year [9]. In Germany, direct costs were similar to the Hungarian data (2,312 Euro), but indirect costs were much higher (for sick-leave 2,835 Euro/patient/year, for a disability pension 8,358 Euro/patient/year) [10].…”

The phenotype and genotype of rheumatoid arthritis in the Democratic Republic of Congo

“…We must also take into account an important morbidity and socio-economic impact [1,2] of this disease as well as an increased cardio-vascular mortality [3-6]. Great strides have been made on RA in recent years, including a better understanding of the genetic aspects, environmental factors and the disease's pathogenesis, at least in the Western world.…”

The impact of rheumatoid arthritis on the economic situation of Polish households

“…In their study, the HAQ score was compared to disease duration and amounted to 0.9 with duration of up to 2 years and 1.6 with duration of more than 10 years [7,17,19]. In the Belgian study (133 participants) patients with early RA (average duration of 0.5 year) had a HAQ score of 1.0 and patients with late RA (average 12.5 years) had a HAQ score of 1.7 [20]. Our data showed that the HAQ score was lower (average = 0.8, median = 0.6) and the results of HAQ analyzed against disease duration were better: 0.5 with duration of up to 2 years and 1.0 with duration of more than 10 years.…”