Objective: Rheumatoid arthritis (RA) is a disease that often requires multiple drug treatment for long periods of time. The purpose of this study was to assess the direct costs of medical care for RA patients seen in a tertiary care center in Mexico City.
Methods: The clinical cases of 3 patients attending our Institution were studied. These represented: (i) one with a disease easily controlled with a disease modifying anti-rheumatic drug (DMARD) (mild disease), (ii) one adequately controlled with 2 or more DMARDs (moderate disease), and (iii) one poorly controlled in spite of multiple DMARDs (severe disease). The costs of the medical visits and of all laboratory and routine examinations during the last year were estimated according to local tabulators, considering the options of highest, intermediate and lowest costs. The costs of the prescribed medications were calculated from current price lists obtained from four drugstores near the Institution.
Results: Medical care to an RA patient costs between US $19 and US $221.70 monthly (US $228.08 and US $2,661.40 per year) depending on the socio-economic status of the patient and on variables related to the activity and severity of the disease in our setting. The number of medical visits represented 0.1% to 12.7% of the total costs, laboratory and routine examinations 0.1% to 7.1%, and medications 81.8% to 99.8%. For reference the minimum wage in Mexico is US $90.40 per month.
Conclusions: The direct costs of medical care to RA patients in our setting can be high, and greatly depends on the prescribed medications.