To estimate healthcare service utilisation costs of patients with rheumatoid arthritis in France and to estimate the fraction of these costs attributable to RA.
The "Échantillon généraliste des bénéficiaires" (EGB) is a 1/97 random sample of the main national claims database covering the French population. A cohort of patients with rheumatoid arthritis was constituted of all adults benefiting from full coverage for rheumatoid arthritis (ICD-10 M05-06) on 1st january 2009. A control group matched for age and gender was identified. Health expenditures were assessed from the payer's perspective for the year 2010.
The annual per capita reimbursed total health expenditure was €6,404 in 2010, an amount around two times higher than in the control group €3,095 (P<0.0001). The main contributors to this extra cost were outpatient care (+€2,407; 72.7%), including medication (+€1,686; 50.0%), and inpatient care (+€903; 27.3%). Patients treated by biological agents generated an age-adjusted per capita annual expenditure about three times higher than untreated patients (€15,757 versus €4,640).
Only half of medical expenditure by patients with rheumatoid arthritis is attributable to their disease and use of biological agents has become a major driver of cost.