Total annual cost of juvenile idiopathic arthritis ranges from $1,100 to $44,800
The total annual costs for the family of a patient with juvenile idiopathic arthritis are substantial, ranging from $1,122 to $44,832, with the highest dollar amounts spent on medication and medical appointments, according to data.
“The treatment of JIA must be multilevel, with a pediatric rheumatologist, psychological support, physical therapy, nutrition and family support,” Fernando García-Rodríguez, MD, of the Autonomous University of Nuevo León, in Mexico, and colleagues wrote. “Some studies have shown that the costs increase in relation to disease activity and progression to disability. With this perspective, considering the multiple medical appointments, laboratory tests, medications and indirect costs, this disease generates elevated costs, which results in a high economic impact for the family.”
“The costs can be dived in those directly related with health care services (direct health care costs), and those not related to health care services (indirect health care costs),” they added. “Therefore, the economic burden for the family depends on factors such as health care coverage available, income status, actual treatment, disability, and the intervention needed. There have been some reports about the costs of illness for JIA, but its variability is important according to the region, social context, and health care system.”
To examine the health care costs associated with JIA treated with biological drugs, García-Rodríguez and colleagues conducted a systematic review of studies published from January 2000 to March 2021. The researchers reviewed studies in MEDLINE, EMBASE, Web of Science, Scopus and the Cochrane Databases, assessed each entry for quality.
In all, 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 medications, medical appointments, laboratory tests, clinical imaging, surgeries, hospitalizations, physiotherapy, devices, alternative medicine, administration of medications, adverse events and complications. Direct costs also included money spent on transportation, home adequacy, caregiver accommodation, travel expenses, informal and formal patient care and insurance payments.
Indirect costs, meanwhile, were defined as those related to lost productivity, including missed school days, missed workdays for the caregiver, general work impact, early retirement and the estimated costs of caregiver productivity.
All costs were converted to U.S. dollars and adjusted for inflation.
According to the researchers, 10 studies reported total costs, ranging from $310 to $44,832 annually. 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 primarily 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, with the highest reported in polyarticular disease.
Total and direct costs increased as much as three-fold after the initiation of biological therapy. The researchers reported a high risk of reporting bias and inconsistency in the methodology used.
“Annual [total costs] ranged from $1,122 to $44,832 USD, at least half of which were related to [direct costs (DC)] in the eight studies that reported both costs,” García-Rodríguez and colleagues wrote. “Unfortunately, detailed information on DC were found in a minority of studies, reporting mostly those related with medications and medical appointments. Besides, the report of [indirect costs] was vague and scarce. Similar costs were found in patients with inflammatory bowel disease.”
“Most studies focus on total or direct costs, while indirect costs are underreported,” they added. “Despite this, the information collected allows us to identify that the costs of JIA are substantial and probably the highest are derived from medication and medical appointments. Which evidences the great economic impact of JIA and how catastrophic it can be for a family.”
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