Burden Of Rheumatoid Arthritis In The Czech Republic - Direct And Productivity Costs

International pharmacoeconomic studies suggest Health Assessment Questionnaire (HAQ) as an important predictor of evaluation both direct and productivity costs. Costs are supposed to increase with increasing HAQ score. Therefore, we calculated direct and productivity costs for five groups of patients according to their HAQ (<0.6, 0.6-1.1, 1.1-1.6, 1.6-2.1, ≥2.1) to confirm this assumption also in the Czech Republic. This calculation was based on a retrospective cross-sectional study. We included 126 patients with rheumatoid arthritis, aged 18-84 years either at working status, part-time disabled or full-time disabled. For estimation of direct medical costs, we used microcosting method retrospectively reviewing individual patients' medical records. For calculation of productivity costs we excluded patients older than 63 years of age (retirement pensioners). We used friction costs approach (FCA) with defined friction period of 130 workdays, based on patients' absenteeism. Productivity of part-time-disabled and full-time disabled patients were assumed to be deteriorated by 52% and 70%, respectively, based on the Czech law on pension insurance. The height of average monthly income in year 2010, €960.3 was used as denominator. Costs were expressed as mean value per one patient with RA in each of the HAQ-group. Average patients′ age was 57.3 years; average time from diagnosis was 17.5 years with mean HAQ score 1.4 and mean DAS28 3.62. Mean annual medical direct costs, for each HAQ-group, were €4076.7, €5950.2, €4691.3, €6932.1, and €6727.1, respectively. Mean annual indirect costs associated with productivity loss were €481.5, €1178.6, €1267.7, €1585.6, and €2122.5, respectively. Direct and productivity costs for patients with rheumatoid arthritis are closely related to the height of HAQ score. Total (direct and productivity) annual mean costs were €7135.6. 31.0% of all patients were treated with biological treatment which represented up to 79.4% of the overall direct medical costs.