Frequency of Health Care Resource Utilization and Direct Medical Costs Associated with Psoriatic Arthritis in a Rheumatic Care Center in Colombia

Abstract

Objective

To estimate the frequency of health care resource utilization and direct medical costs associated with Psoriatic Arthritis (PsA) in a rheumatic care center in Colombia.

Methods

A retrospective prevalence-based cost of illness study under the Colombian health care system perspective was conducted. We analyzed the frequency of health care resource utilization and estimated direct medical costs using anonymized medical records of adult patients (≥18 years) diagnosed with PsA at a rheumatology care center in Bogotá, Colombia. Patients were required to have at least one medical visit linked to a PsA diagnosis (ICD-10 L40.5) between October 2018 and October 2019 and a previous diagnose by the CASPAR criteria. Data on hospitalization episodes was not available. Direct medical costs were estimated in Colombian pesos (COP) and reported in US dollars (USD) using an exchange rate of 1USD = 3263.4 COP. A multivariate generalized linear model was used for identifying potential cost predictors.

Results

A sample of 83 patients was obtained. Of these, 54.2% were women and had a mean (SD) age of 58.7 (12) years at baseline. On average, they had 2.2 and 3.8 medical visits to the dermatologist and rheumatologist in the study period. The total direct medical cost was estimated at 410,985 US Dollars. Medical visits, therapies, laboratory and imaging represented 3.2% of total expenses and medications the remaining 96.8%. Patients receiving conventional DMARDs (cDMARDs) had an associated mean cost of 1020.1 USD (CI 701.4–1338.8) in a year. Among patients treated with cDMARDs and biological DMARDs (bDMARDs) the mean cost increase to 8113.9 USD (SD 5182.0–95% CI 6575.1–9652.8).

Conclusion

A patient under biological therapy can increase their annual cost by 7.9 times the cost of a patient in conventional therapy. This provided updated knowledge on the direct medical costs, from the provision of a rheumatic care center service, to support epidemiologic or pharmacovigilance models.

Keywords:

• psoriatic arthritis
• direct medical costs
• treatment

Statements of Ethical Approval

This study was approved by the Research Committee of Biomab Health Care Center in February 2019. All patients had previously signed informed consent for data use. This study did not represent risks for the patients according to the Resolution 8430 of 1993 of the Ministry of Health of Colombia. All data that could identify a patient were anonymized.

Acknowledgments

We thank Biomab Health Care Center for the administrative data provided for this study.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Dr Pedro Santos-Moreno reports grants, personal fees, and non-financial support from Pfizer, Janssen, Biopas - UCB, and Abbvie, and personal fees and non-financial support from Roche, Bristol, Lilly, and Sanofi, outside the submitted work. The authors report no other potential conflicts of interest for this work.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.