Clinical Rheumatology

, Volume 24, Issue 6, pp 615–619 | Cite as

Healthcare consumption and direct costs of rheumatoid arthritis in Belgium

  • R. Westhovens
  • A. Boonen
  • L. Verbruggen
  • P. Durez
  • L. De Clerck
  • M. Malaise
  • H. Mielants
Original Article


The aim of this study was to compare the socioeconomic consequences of early and late rheumatoid arthritis in Belgium and to assess the patient out-of-pocket contributions. This multicentre longitudinal study in Belgium evaluated patients with rheumatoid arthritis. Early disease was defined as diagnosis since less than 1 year. At baseline sociodemographic and disease characteristics were assessed and during the following year patients recorded all healthcare- and non-healthcare-related direct costs and out-of-pocket contributions. The study included 48 patients with early and 85 patients with late rheumatoid arthritis. Mean disease duration was 0.5 vs 12.5 years in patients with early and late rheumatoid arthritis, respectively. The disease activity score (DAS28) was comparable between both groups (4.1 vs 4.5, p=0.14), but physical function (Health Assessment Questionnaire, HAQ) was more impaired in patients with long-standing disease (1.0 vs 1.7, p<0.001). Work disability had increased from 2% in patients with early to 18% in patients with late disease. The annual societal direct costs per patient were € 3055 (median: € 1518) opposed to € 9946 (median: € 4017) for early and late rheumatoid arthritis, respectively. The higher direct cost for patients with long-standing disease was seen for all categories, but especially for physiotherapy and need for devices and adaptations. Patients with early as well as late disease contribute out of pocket about one-third to the direct healthcare costs. Within each group, HAQ was a strong determinant of costs. In Belgium, patients with long-standing rheumatoid arthritis are nine times more likely to be work disabled than patients with less than 1 year disease duration and have a threefold increase in costs. Differences in healthcare consumption between patients could be mainly explained by differences in physical function (HAQ).


Cost of illness Rheumatoid arthritis 



The authors wish to thank Dr. Veerle Taelman, Dr. Kristien Maenaut, Dr. Kathleen Declerck, Dr. Ellie Kruithof and all the participating patients for their tremendous effort to collect all the data. This study was financially supported by an Educational Grant from Aventis Belgium.


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Copyright information

© Clinical Rheumatology 2005

Authors and Affiliations

  • R. Westhovens
    • 1
    • 8
  • A. Boonen
    • 2
  • L. Verbruggen
    • 3
  • P. Durez
    • 4
  • L. De Clerck
    • 5
  • M. Malaise
    • 6
  • H. Mielants
    • 7
  1. 1.Department of RheumatologyUniversity Hospitals KU LeuvenLeuvenBelgium
  2. 2.Department of Internal Medicine, Division of RheumatologyUniversity Hospital Maastricht and Caphri Research InstituteMaastrichtThe Netherlands
  3. 3.Rheumatology Unit, Academic HospitalVrije Universiteit BrusselBrusselsBelgium
  4. 4.Department of Rheumatology, Cliniques Universitaires Saint-LucUniversité Catholique de LouvainBrusselsBelgium
  5. 5.Department of Clinical Immunology and RheumatologyUniversity Hospital AntwerpAntwerpBelgium
  6. 6.Department of RheumatologyUniversity of LiègeBelgium
  7. 7.Department of RheumatologyUniversity Hospital Gent and AZ St-Augustinus WilrijkBelgium
  8. 8.Department of RheumatologyUniversity Hospital GasthuisbergLeuvenBelgium

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