Il costo dell’Artrite Reumatoide: l’esperienza dell’ASL della Provincia di Pavia

Summary

Rheumatoid Arthritis (RA) is a chronic, generally progressive, autoimmune disease that affects between 0.5 and 1.0% of the adult population worldwide. It is more prevalent among women, increases with aging and is associated with significant pain, joint destruction and premature mortality. This disease also affects patients’ psychological and social health with considerable economic consequences. The aim of our work is to provide potentially useful information about the burden of RA, a disease whose cost has received limited attention so far in Italy. An observational, retrospective, prevalence-based study was carried out through record linkage of administrative and demographic databases of hospitalizations, pharmaceutical prescriptions and outpatient services. Data included the Diagnosis Related Groups (DRGs), regional outpatient tariffs and the Italian market price for drugs. A sample of 1596 patients (mean age = 62.5 years; females = 75.8%) out of a population of over 500,000 covered by a Local Health Unit in Northern Italy (Pavia) were recorded with diagnosis of RA (0.31 prevalence rate). Annual mean direct medical cost was € 3,556.63 (DS ± 5,773.25); drug cost was € 1,915.01 (53.8% of the total) whereas hospitalizations costed € 995.04 (28.0%), diagnostic investigations € 527.14 (14.8%) and Day Hospital admissions € 119.45 (3.4%). Approximately 9.4% of patients were receiving biologic therapy and 70.5% of patients DMARDs. Overall, 91,197 outpatient services and 417 hospitalizations (4587 days) for RA patients were carried out.

In summary, we analysed cost categories with high expenditure and clarified demographic variables associated with high cost in chronic disease such as RA, in order to ease the burden of RA on affected patients and to reduce its relevant economic impact on resource consumption from the Health Service of Regione Lombardia perspective.