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

Figures & data

Table 1 Baseline Sociodemographic Characteristics of the Study Sample

Characteristics	n (%)
N	83
Sex
Female	45 (54.2)
Age (years) mean (SD)	58.7 (12)
Comorbidities
Primary hypertension	4 (4.8)
Intervertebral disc disorders	3 (3.6)
Obesity	3 (3.6)
Osteoporosis without fracture	3 (3.6)
Fibromyalgia	3 (3.6)

Table 2 Frequency of Health Care Services and Medication Utilization

Medical Services/Medications	n (%)	Mean	SD
Medical appointments
Rheumatology	82 (98.8)	3.9	1.5
Dermatology	65 (78.3)	2.8	1.2
Physiatry	44 (53.0)	1.7	1.0
Orthopedics	7 (8.4)	1.4	0.9
Other specialties*	30 (36.1)	1.8	1.2
Physical therapy	30 (36.1)	1.9	1.0
Laboratory tests and imaging	36 (43.4)	2.0	1.5
Medications
NSAIDs+	16 (19.3)	0.4	1.0
Analgesics	43 (51.8)	1.6	1.8
Conventional DMARDs**	71 (85.5)	3.6	2.8
Biological DMARDs	46 (55.4)	2.2	2.2

Notes: *Psychology, infectology, pain and palliative care, nutrition and dietetics, psychiatry.

Abbreviations: +NSAIDs, non-steroidal anti-inflammatory medicine; **DMARDs, disease-modifying antirheumatic drugs.

Table 3 Distribution of Patients According to the Type of Pharmacological Therapy Received

Treatment without Biological Therapies	Number of Patients	Treatment Including Biological Therapies	Number of Patients
NSAIDs	0	bDMARDs	3
Analgesics	2	bDMARDs + NSAIDs	3
cDMARDs	10	bDMARDs + cDMARDs	18
cDMARDs + NSAIDs	0	bDMARDs + cDMARDs + NSAIDs	3
cDMARDs + analgesics	16	bDMARDs + cDMARDs + analgesics	15
cDMARDs + NSAIDs + analgesics	6	bDMARDs + NSAIDs + analgesics	1
		bDMARDs + NSAIDs + analgesics + cDMARDs	3

Abbreviations: +NSAIDs, non-steroidal anti-inflammatory medicine; cDMARDs, conventional disease-modifying antirheumatic drugs; bDMARDs, biological disease-modifying antirheumatic drugs.

Table 4 Unadjusted Annual Mean and Median PsA-Related Medical Costs

Cost Component	Mean	SD	Median
Medical appointments
Rheumatology	54.5	21.8	56.4
Dermatology	24.4	10.2	26.0
Physiatry	14.8	9.1	8.7
Orthopedics	12.2	7.8	8.7
Other specialties*	6.3	3.6	5.7
Physical therapy	5.9	3.2	6.1
Laboratory tests and imaging	51.2	52.1	21.3
Medications
NSAIDs+	5.8	23.4	0.0
Analgesics	1.9	55.6	1.7
Conventional DMARDs**	840.3	980.8	324.3
Biologic DMARDs	4,106.1	5,017.0	2,145.0

Notes: *Psychology, infectology, esp. in pain and palliative care, nutrition, and dietetics, psychiatry.

Abbreviations: +NSAIDs, non-steroidal anti-inflammatory medicine; **DMARDs, disease-modifying antirheumatic drugs.

Figure 1 Comparison of the annual average medical direct cost of PsA by sex, age groups and type of DMARD. (A) Average cost by sex. (B) Average cost by age range. (C) Average cost by type of DMARD.

Notes: (A) Ratio male:female = 1.3. (B) Ratio <60 years old:60 years and over = 1.4. (C) Ratio bDMARDs:cDMARDs = 7.9.

Table 5 Comparison of Direct Medical Costs According to the Type of Disease Modifying Anti-Rheumatic Drugs Received, Sex and Age Group

Calculations	Type of Pharmacological Therapy	Female (n=45)		Male (n=38)
		Under 60 Years (n=24)	60 Years and Over (n=21)	Under 60 Years (n=24)	60 Years and Over (n=14)
Sum	cDMARDs	17.605, 0	13.257, 0	4.010, 2	2.673, 9
	bDMARDs	75.084, 5	90.368, 4	172.972, 6	34.815, 2
Mean	cDMARDs	1.354, 2	1.325, 7	1.002, 5	382, 0
	bDMARDs	6.825, 9	10.040, 9	8.648, 6	5.802, 5
Median	cDMARDs	1.511, 9	1.704, 0	489, 8	325, 6
	bDMARDs	6.466, 1	8.369, 9	6.435, 1	6.205, 6
Min.	cDMARDs	88, 5	162, 9	111, 2	140, 2
	bDMARDs	1.754, 2	3.824, 6	1.869, 7	2.938, 9
Max.	cDMARDs	2.903, 8	2.747, 5	2.919, 3	736, 0
	bDMARDs	14.267, 2	21.256, 4	19.957, 0	7.736, 4
SD	cDMARDs	956, 8	979, 7	1.291, 6	221, 1
	bDMARDs	4.555, 4	5.357, 1	5.926, 0	1.709, 4

Abbreviations: cDMARDs, conventional disease-modifying antirheumatic drugs; bDMARDs, biological disease-modifying antirheumatic drugs.

Figure 2 Cost per patient with PsA by sex and age groups and its statistical differences. (A) Boxplot by sex. (B) Boxplot by age groups.

Notes: Prepared by the authors from their data base. (A) No statistical differences in costs by sex. Mann–Whitney: U = 735, P = 0.13. (B) Statistical differences in costs by age groups. Mann–Whitney: U = 649, P = 0.03.

Table 6 Multivariate Regression Analysis of Direct Medical Costs

Characteristics	Cost Ratio	95% CI	p-value
(Intercept)	1269	920, 1797	<0.001
Sex
Male (ref: female)	0.66	0.46, 0.97	0.024
Age
≥60 years (ref:<60)	0.75	0.53, 1.08	0.11
Use of bDMARDs	9.00	6.22, 13.0	<0.001

Abbreviation: CI, confidence interval.