Direct Costs of Rheumatoid Arthritis among Patients with Biological Therapy in Morocco: ECORAM Study

Objective The present study aims to estimate the annual direct costs of rheumatoid arthritis (RA) among patients with biological therapy in Morocco from the societal perspective and, to identify factors affecting the increase of direct costs. Methods This is a descriptive, observational, and ambispective cohort study which was accomplished over one year, from July 2019 to October 2020, with a follow-up after 6 months since the inclusion’s date. study, conducted in 110 patients with RA and under BDMARDs from July 2019 until October 2020. The data collection was done by face-to-face interviews using a questionnaire. Additional information was obtained from the patient’s files. Results The mean age of patients was 50.5 years old with 85% of women. The annual average total direct costs are $7,659 with a minimum and a maximum of $1,889.5 and $29,158.3 respectively. The medical costs represent 98% with the majority of BDMARDs (67%) at $4,944.73, followed by hospitalization costs (12%) at $889. The remaining 20% includes the other costs ($1,825). The RAMED (Régime assistance Médicale) paid around 47% of the total medical costs which is $3,445.56, and the health insurance organizations (CNOPS, CNSS, private insurance) paid $2,876.7 (39%), while patients paid $1,048.65 (14%) on medical and non-medical costs. The following factors were significantly associated with total direct costs of RA: marital status, number of children, working status, monthly household income, medical insurance, disease duration, to undergo surgery, DMARDs, NSAIDs and antalgic, and the class of BDMARDs. Conclusion The economic burden of RA is very high for the study population since the majority are vulnerable and have a monthly household income of less than $250. Further, two-thirds of patients had the RAMED, which supports almost all the medical costs. However, the costs paid by the patient are about one third of their annual household income.