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One-year direct costs of biological therapy in rheumatoid arthritis and its predictive factors: data from the Moroccan RBSMR registry

  • Pharmacoeconomics
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Abstract

The aim of the study was to estimate the annual direct costs of biological therapies in rheumatoid arthritis (RA), and to establish possible factors associated with those costs. The main data source was the Moroccan registry of biological therapies in rheumatic diseases (RBSMR Registry). We included patients with available 1-year data. Variables related to socio-economic status, disease and biological therapy were collected. Direct costs included prices of biologics, costs of infusions, and subcutaneous injections. Differences in costs across groups were tested by Mann–Whitney and Kruskal–Wallis tests. Correlations analysis was performed in search of factors associated with high costs. We included 197 rheumatoid arthritis patients. The mean age was 52.3 ± 11 years, with female predominance 86.8%. Receiving one of the following therapies: rituximab (n = 132), tocilizumab (n = 37), or TNF-blockers (n = 28). Median one-year direct costs per patient were €1665 [€1472–€9879]. The total annual direct costs were € 978,494. Rituximab, constituted 25.7% of the total annual budget. TNF-blockers and tocilizumab represented 27.3% and 47% of this overall budget, respectively. Although the costs were not significantly different in terms of gender or level of study, the insurance type significantly affected the cost estimation. A positive correlation was found between the annual direct cost and body mass index (r = 0.15, p = 0.04). In Morocco, a developing country, the annual direct costs of biological therapy are high. Our results may contribute to the development of strategies for better governance of these costs.

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Acknowledgements

The authors would like to thank the scientific committee and national principal investigators of the RBSMR study: Lahsen Achemlal, Fadoua Allali, Rachid Bahiri, Redouane Abouqal, Imane El Bouchti, Imad Ghozlani, Abdellah El Maghraoui, Taoufik Harzy, Ihsane Hmamouchi, Linda Ichchou, Hasna Hassikou, Ouafa Mkinsi, and Redouane Niamane; patients who agreed to participate in this study.

Funding

Data collection for the Moroccan Registry of biotherapy “Registre de Biothérapies de la Société Marocaine de Rhumatologie” (RBSMR) was supported by an unrestricted Grant from Pfizer, Novartis, Janssen, and Abbvie. The ancillary study described in this manuscript was conducted without any type of funding.

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Authors and Affiliations

  1. Department of Rheumatology B, El Ayachi Hospital, Ibn Sina University Hospital, Salé, Morocco

    Safaa Fellous, Hanan Rkain, Latifa Tahiri & Fadoua Allali

  2. Physiology Laboratory, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco

    Hanan Rkain

  3. Research Team of Pharmacoeconomics and Pharmacoepidemiology, Mohammed V University, Rabat, Morocco

    Samir Ahid

  4. Laboratory of Biostatistical, Clinical and Epidemiological Research, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco

    Redouane Abouqal & Ihsane Hmamouchi

  5. Department of Rheumatology, Provincial Hospital of Temara, Temara, Morocco

    Ihsane Hmamouchi

  6. Department of Rheumatology, Military Hospital Mohammed V, Ibn Sina University Hospital, Rabat, Morocco

    Lahsen Achemlal

  7. Department of Rheumatology, Arrazi University Hospital, Marrakech, Morocco

    Imane El Bouchti

  8. Private Medical Office, Rabat, Morocco

    Abdellah El Maghraoui

  9. Department of Rheumatology, University Hospital of Agadir, Agadir, Morocco

    Imad Ghozlani

  10. Department of Rheumatology, Military Hospital Moulay Ismail, Hassan II University Hospital, Meknès, Morocco

    Hasna Hassikou

  11. Department of Rheumatology, Hassan II University Hospital, Fès, Morocco

    Taoufik Harzy

  12. Department of Rheumatology, Mohammed VI University Hospital, Oujda, Morocco

    Linda Ichchou

  13. Department of Rheumatology, Ibn Rochd University Hospital, Casablanca, Morocco

    Ouafa Mkinsi

  14. Department of Rheumatology, Military Hospital Avicenne, Mohammed VI University Hospital, Marrakech, Morocco

    Radouane Niamane

  15. Department of Rheumatology A, El Ayachi Hospital, Ibn Sina University Hospital, Salé, Morocco

    Rachid Bahiri

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  1. Safaa Fellous
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  2. Hanan Rkain
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Contributions

All authors have contributed substantially to the content of the manuscript. SF, HR, FA, LT and SA contributed to the conception and design of the study. SF, HR, LA, IE, IG, HH, LI, OM, RN, RB acquired the data. SF and HR analysed and interpreted the results. SF drafted the article. RA critically revised it. The scientific committee of the RBSMR study has reviewed and approved the final manuscript.

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Correspondence to Safaa Fellous.

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Fellous, S., Rkain, H., Ahid, S. et al. One-year direct costs of biological therapy in rheumatoid arthritis and its predictive factors: data from the Moroccan RBSMR registry. Rheumatol Int 41, 787–793 (2021). https://doi.org/10.1007/s00296-020-04762-7

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