The total annual cost of juvenile idiopathic arthritis ranges from $ 1,100 to $ 44,800

The total annual costs to the family of a patient with juvenile idiopathic arthritis are substantial, ranging from $ 1,122 to $ 44,832, with the highest amounts going for drugs and medical appointments, according to the data.

“The treatment of JIA should be at several levels, with a pediatric rheumatologist, psychological support, physical therapy, nutrition and family support” Fernando García-Rodriguez, MD, from the Autonomous University of Nuevo León, Mexico, and colleagues wrote. “Some studies have shown that costs increase with disease activity and progression to disability. In this perspective, given the multiple medical appointments, laboratory tests, drugs and indirect costs, this disease generates high costs, which translates into a significant economic impact for the family.

“Costs can be categorized between those directly related to health services (direct costs of health care) and those that are not related to health services (indirect costs of health care),” they added. “Therefore, the economic burden on the family depends on factors such as health care coverage available, income level, actual treatment, disability and the intervention needed. There have been a few reports on the costs of the disease for JIA, but its variability is significant by region, social context and health system. “

To examine the health care costs associated with JIA treated with biologic drugs, García-Rodríguez and colleagues conducted a systematic review of studies published from January 2000 to March 2021. Researchers reviewed studies in MEDLINE, EMBASE , Web of Science, Scopus and Cochrane. Databases, rated each entry for quality.

In total, the researchers included 18 eligible primary studies – with a combined total of 6,540 patients – that reported total direct and / or indirect costs related to JIA for at least 1 year.

Direct costs were defined as those spent on drugs, medical appointments, lab tests, clinical imaging, surgeries, hospitalizations, physiotherapy, devices, alternative medicine, drug administration , adverse events and complications. Direct costs also included money spent on transportation, adequate housing, accommodation for caregivers, travel costs, informal and formal patient care, and insurance payments.

Indirect costs, on the other hand, were defined as those related to lost productivity, including missed school days, missed working days for the caregiver, general impact on work, early retirement and the estimated costs of caregiver productivity.

All costs have been converted to US dollars and adjusted for inflation.

According to the researchers, 10 studies reported total costs, ranging from $ 310 to $ 44,832 per year. Direct costs were reported in 16 articles, ranging from $ 193 to $ 32,446, and accounted for approximately 55% to 98% of total costs. These costs were mostly associated with medications and medical appointments, the researchers wrote.

A total of six included studies reported indirect costs, which ranged from $ 117 to $ 12,385, and four studies reported costs based on JIA category, the highest reported in polyarticular disease.

The total and direct costs tripled after the start of biological therapy. The researchers reported a high risk of reporting bias and inconsistency in the methodology used.

“Annual [total costs] ranged from US $ 1,122 to US $ 44,832, of which at least half were related to [direct costs (DC)] in the eight studies that reported both costs, ”wrote García-Rodríguez and colleagues. “Unfortunately, detailed information on DC has been found in a minority of studies, mainly reporting those related to medications and medical appointments. In addition, the report of [indirect costs] was vague and rare. Similar costs have been found in patients with inflammatory bowel disease.

“Most studies focus on total or direct costs, while indirect costs are underestimated,” they added. “Despite this, the information gathered allows us to identify that the costs of JIA are substantial and probably the highest come from drugs and medical appointments. Which shows the great economic impact of AJI and how catastrophic it can be for a family. “