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*Lubomir Marinov, Valentina Petkova, Irina Nikolova, Alexandra Savova,Guenka Petrova

1Medical University – Sofia, Faculty of Pharmacy, Department of Pharmacology, toxicologyand pharmacotherapy, Dunav str., Sofia 1000, BULGARIA.

2Medical University – Sofia, Faculty of Pharmacy, Department of Organisation and economyof Pharmacy, Dunav str., Sofia 1000, BULGARIA.


The goal of this pilot study is to perform a cost analysis by using patients with rheumatoid arthritis as a source of information. The point of view is that of the patients and society and the time horizon is one year. It is a micro costing study calculating the direct health care cost of pharmacotherapy. The pharmacotherapy includes 6 main therapeutic groups of medicines as corticosteroids (per os or intraarticular injections), disease modifying antirheumatics (DMAR), biological, non-steroidal anti-inflammatory drugs (NSAID), medicines improving bone density, and proton pump inhibitors (PPI).Monthly cost of pharmacotherapy per patient on average is 815.05 (SD 1104.25) BGN, and biological therapy is the most expensive one 2961.03 (SD 1435.46). 25% of the patients are on it. 58 per cent of the patients reported regular physicians’ visits at least ones quarterly with average yearly cost of 111.60 BGN (9.30 BGN per month). 56 people were out of work and for 13 of them it was for more than 20 days (6.18 days per patient per year on average). This consumes 147.17 BGN per patient per year (12.26 BGN per month). 85 people were hospitalized during the year and this consumes 589.65 BGN per patient per year (49.13 BGN per month). The structure of the monthly cost per patient with RA shows that pharmacotherapy is with the highest value with relative share (92%) out of the observed health and non health care resources used. The next cost by value is the hospitalization cost (6%). The cost of RA is high and medicines are the main cost drivers. Micro-costing based on patients as source of information is not completely reliable and provides subjective information about the cost of the therapy.

Keywords: pharmacotherapy, rheumatoid arthritis, cost of illness, patients reported cost.

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