The direct medical cost of rheumatoid arthritis in Hong Kong

Figures & data

Table 1. Rheumatoid arthritis-related direct cost domains

Cost items
Inpatient management
Hospitalisation (days of hospital stay)
Procedures (surgeries, investigations)
Laboratory monitoring
Medications
Outpatient management
Clinic visits
Outpatient surgery
Diagnostic/therapeutic procedures and tests (e.g. radiography)
Emergency room visits
Medications (DMARDs, NSAIDs, steroids, analgesics, supplements)
Non-physician service utilisation (physiotherapist, occupational therapist, rehabilitation)
Cost for management/prophylaxis of side effects
Medications (gastroprotective drugs)
Investigations, monitoring (e.g. oesophagogastroduodenoscopy)
Clinic visits (e.g. eye clinic)

DMARDs, disease-modifying antirheumatic drugs; NSAIDs, non-steroidal anti-inflammatory drugs.

Table 2. Demographic characteristics of the subjects*

Characteristic	Male	Female	All patients	p-value
Age (years)			54.7 ± 10.9
Gender, n (%)	34 (23.1)	113 (76.9)	147 (100)
Weight (kg)			54.5 ± 9.3
Duration of disease (years)			12.6 ± 7.0
No. of swollen joints			1.76 ± 2.04
No. of tender joints			1.42 ± 2.06
Early morning stiffness (min)			27.3 ± 62.7
ESR			36.2 ± 25.0
Age group (years), n(%)
<50	5 (14.7)	42 (37.2)	47 (32.0)	<0.01
50–60	17 (50.0)	42 (37.2)	59 (40.1)
>60	12 (35.3)	29 (25.7)	41 (27.9)
Disease severity, n (%)
Functional class I	18 (52.9)	44 (38.9)	62 (42.2)	>0.1
Functional class II	13 (38.2)	62 (54.9)	75 (51.0)
Functional class III	3 (8.8)	7 (6.2)	10 (6.8)
Duration of disease (years)	11.44 ± 6.24	12.95 ± 7.23

ESR, erythrocyte sedimentation rate (patients performed this test in the study period; n = 64).

*Data are mean ± standard deviation unless otherwise stated.

Table 3. Comparison of demographic data in patients with at least one hospital admission during the study period

	Hospitalisation, n (%)	Without hospitalisation, n (%)	All patients	p-value
No. of patients	18	129	147
Sex
Male	2 (11.1)	32 (24.8)	34 (23.1)	>0.1
Female	16 (88.9)	97 (75.2)	113 (76.9)
Age group (years)
<50	5 (27.8)	42 (32.6)	47 (32.0)	>0.1
50–60	9 (50.0)	50 (38.8)	59 (40.1)
>60	4 (22.2)	37 (28.7)	41 (27.9)
Disease severity
Functional class I	4 (22.2)	58 (45.0)	62 (42.2)	>0.1
Functional class II	11 (61.1)	64 (49.6)	75 (51.0)
Functional class III	3 (16.7)	7 (5.4)	10 (6.8)
Duration of disease (years) (mean ± sd)	13.5 ± 7.22	12.47 ± 6.96

sd, standard deviation.

Table 4. Direct medical cost of rheumatoid arthritis per patient per year

	Mean cost per patient year (HK$)	Median cost per patient per year (range) (HK$)	% of total
Inpatient cost	8,171.2	0 (0–209,921)	43.8
Outpatient cost	2,872.2	2,800 (700–10,900)	15.4
Laboratory cost	3,574.8	3,350 (0–8,510)	19.2
Radiography	1,368.6	0 (0–14,320)	7.3
Minor surgery	265.3	0 (0–7,500)	1.4
Drug cost	1,827.6	1,304 (0–12,879)	9.8
Management of side effects	577.6	66 (0–6,000)	3.1
Total	18,657.2	10,095 (1,400–21,715)	100.0
	Age group
	<50 years (n = 47)	50–60 years (n = 59)	>60 years (n = 41)
Average (± sd) cost of outpatient (HK$)	2,646 ± 1,199	3,061 ± 1,611	2,860 ± 1,060
Hospital stay in the past 12 months (HK$)
Average (± sd) cost of surgery	8,484 ± 30,941	1,233 ± 7,177	2,838 ± 10,559
Average (± sd) hospital cost	13,700 ± 47,007	3,978 ± 14,260	7,868 ± 29,929
Average (± sd) cost contributed to side-effect monitoring (HK$)
Laboratory cost	121 ± 289	227 ± 408	159 ± 420
OGD	128 ± 612	51 ± 391	0 ± 0
Liver biopsy	0 ± 0	102 ± 781	0 ± 0
Cost of eye clinic attendance	298 ± 579	190 ± 564	364 ± 613
Drug cost for management or prophylaxis of side effects	42 ± 8	26 ± 82	16 ± 30
Average total cost arising from side effect of medications	588 ± 859	596 ± 1,049	589 ± 678
Average (± sd) drug cost for disease management (HK$) [%]
NSAIDs	190 ± 326 [11.9]	306 ± 497 [14.5]	176 ± 271 [10.3]
DMARDs	1,285 ± 1,691 [80.8]	1,564 ± 2,219 [74.3]	1,455 ± 1,713 [85.2]
Glucocorticoids	33 ± 85 [2.1]	19 ± 41 [0.9]	15 ± 27 [0.9]
Analgesics	9 ± 29 [0.6]	20 ± 33 [1.0]	29 ± 35 [1.7]
Others	72 ± 140 [4.5]	196 ± 1,028 [9.3]	31 ± 64 [1.8]
Total drug cost	1,590 ± 1,798	2,105 ± 2,460	1,707 ± 1,724
Total (± sd) cost of laboratory monitoring (HK$)	3,676 ± 1,739.59	3,597 ± 1,728.88	3,427 ± 1,743.46
Total (± sd) cost of radiological procedure (HK$)	1,158 ± 2,090.44	1,769 ± 2,640.3	1,034 ± 1,712.7

sd, standard deviation; HK$, Hong Kong dollar; OGD, oesophagogastroduodenoscopy; NSAIDs, non-steroidal anti-inflammatory drugs; DMARDs, disease-modifying antirheumatic drugs.