Patients with rheumatoid arthritis consume large proportion of their monthly and annual income due to continuous treatment, frequent hospital visits, laboratory monitoring after defined intervals and hence loss of employment due to disability and pain may be the outcome which leads to economic burden on individual, whole society and health care system. The study aims to evaluate the cost effectiveness of traditional disease modifying antirheumatic drugs used in the management of rheumatoid arthritis and the disease burden on affected population.
Materials and Methods: A retrospective, observational and questionnaire based study was designed to evaluate cost effectiveness of disease modifying antirheumatic drugs and disease burden on outpatients of a hospital of Lahore Pakistan during the period July-2017 to September-2017. Both male and female patients with 30-55 years age were included. Data was collected from prescriptions of 100 randomly selected patients and was analyzed using statistic mean and rheumakit Health Assessment Questionnaire-Disability Index (HAQ-DI) score calculator.
Results: The results showed that all the patients were on combination therapy of disease modifying antirheumatic drugs. Average cost per patient was found to be PKR 1484.1, PKR 660.33, PKR 1044.03, PKR 1734.03, and PKR 1594 for sulfasalazine + hydroxychloroquine, methotrexate + hydroxychloroquine, methotrexate + sulfasalazine, methotrexate + sulfasalazine + leflonamide and hydroxychloroquine + sulfasalazine + methotrexate respectively.
Conclusion: Methotrexate + Hydroxychloroquine combination was found to be cost effective. The average direct cost per patient per month was PKR 4611.87 and PKR 55,324.44 annualy (USD 850.426). Total increase in cost was approximately two times due to adverse effects of therapy.