Direct and indirect costs of rheumatoid arthritis and related conditions in France: a 2015-2023 nation-wide...

Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with substantial healthcare utilization and productivity losses. Advances in RA management may have modified its economic burden. Our aim was to describe the evolution of direct and indirect costs of RA and related conditions in France between 2015 and 2023, using nation-wide data.

We conducted a retrospective population-based study using the National Health Data System (SNDS), covering nearly the entire French population. Patients with RA or related conditions were identified using validated algorithms. Annual reimbursed expenditures including direct medical costs (hospitalizations, outpatient care, medications) and indirect costs (daily allowances, disability benefits, annuities) were analyzed.

The number of patients with RA increased by 26% between 2015 and 2023, from 265,270 to 334,290 individuals. Total reimbursed expenditures increased in similar proportions, from €885.9 million to €1118.3 million, resulting in stable mean costs of €3345 per patient per year, in 2023. However, medication costs increased disproportionately compared with overall spending, rising from €404.3 million in 2015 to €563.9 million in 2023 (+39%). Until 2019, hospitalizations and outpatient consultations in the public sector constituted the second largest expenditure category after medications. However, from 2020 onward, indirect costs emerged as the second largest component and increased strongly over the study period (+48%).

The economic burden of RA in France has grown substantially, with a shift toward higher medication and indirect costs. These findings highlight the importance of incorporating productivity losses into economic evaluations to better inform healthcare policy and resource allocation.