Indirect costs of rheumatoid arthritis in Brazil

OBJECTIVE

The present study aimed to determine indirect costs of rheumatoid arthritis (RA) in a sample of patients followed at a public health-care facility in Brazil. Factors potentially associated with higher indirect costs in these patients were also investigated.

METHODS

This cross-sectional study included patients between 18 and 65 years old with RA according to the American College of Rheumatology criteria. Patients who were working, on sick leave or retired early due to RA were invited to participate in the survey. A systematic structured interview was conducted in all patients including demographic, socioeconomic, and clinical variables and an experienced rheumatologist examined all patients. Estimates of the indirect costs in the preceding 12 months were performed using the human-capital approach based on the society perspective. Multiple linear regression models were used to determine the variables associated with higher indirect costs.

RESULTS

A total of 192 patients were included in the study. Forty-seven of them (24.5%) had retired early due to RA, 62 others (32.3%) were on sick leave due to RA while 83 patients (43.2%) were working at the time of the interview. Estimated indirect cost for this population was US$ 466,107.81 or US$ 2,423.51 per patient per year. Factors associated with higher costs were RA poor functional class, high socioeconomic status and male patients (p < 0.001).

CONCLUSIONS

Estimated costs found in our population are similar to that described in more developed countries. Indirect costs were higher in patients with poor functional classes, high socioeconomic status, and men.

Health and work productivity assessment: state of the art or state of flux?

This article describes current models and methods for productivity measurement in health care research, examines different methods of data collection, and assesses the ease in which they may be used in research. Specific issues regarding the validity of current measurement tools and self-reported data are examined. Concerns about the interpretation of study results, international adaptation of work productivity questionnaires, and regulatory issues also are reviewed.