DIRECT COSTS OF MEDICAL ATTENTION TO MEXICAN PATIENTS WITH RHEUMATOID-ARTHRITIS IN A TERTIARY CARE CENTER

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 c ases of 3 patients attending our Institution were studied. These repre sented: (i) one with a disease easily controlled with a disease modify ing anti-rheumatic drug (DMARD) (mild disease), (ii) one adequately co ntrolled with 2 or more DMARDs (moderate disease), and (iii) one poorl y controlled in spite of multiple DMARDs (severe disease). The costs o f the medical visits and of all laboratory and routine examinations du ring the last year were estimated according to local tabulators, consi dering the options of highest, intermediate and lowest costs. The cost s of the prescribed medications were calculated from current price lis ts obtained from four drugstores near the Institution. Results: Medica l care to an RA patient costs between US$ 19 and US$ 221.70 monthly (U S$ 228.08 and US$ 2,661.40 per year) depending on the socio-economic s tatus of the patient and oil variables related to the activity and sev erity of the disease in our setting. The number of medical visits repr esented 0.1% to 12.7% of the total costs, laboratory and routine exami nations 0.1% to 7.1%, and medications 81.8% to 99.8%. For reference th e minimum wage in Mexico is US$ 90.40 per month. Conclusions: The dire ct coals of medical care to RA patients in our setting can be high, an d greatly depends on the prescribed medications.