Economic burden of rheumatoid arthritis: a systematic review

Objective. To summarize the state of knowledge with regard to the economic impact of rheumatoid arthritis (RA) and to highlight any weaknesses in the work conducted to date, so as to inform future RA cost-of-illness studies. Methods. Four computerized literature databases were searched to identify all the literature relevant to this review. Seven elements indicating a quality cost-of-illness study were established and used to appraise the literature identified critically. Where possible, costs reported by the different studies were converted to 1996 US dollars using the consumer price index for medical care. Results. Total average medical costs were reported to range from US$5720 (UK pound 3575) to US$5822 (UK pound 3638). Medication constituted between 8 and 24% of total medical costs, physician visits between 8 and 21%, and in-patient stays between 17 and 88%. The average number of days absent from work due to a person's RA was reported to range from 2.7 to 30 days/year. Conclusion. The economic impact of RA in terms of cost was reported to be substantial by all studies reviewed. However, methodological problems meant that discrepancies in the average (per person) annual cost of RA existed across studies.