A Comparative Study On Pharmacoeconomic Analysis Of Rheumatoid Arthritis Patient In Two Different Hospitals In Tamil Nadu

ABSTRACT

Objective: The objective of the present study is to compare the prescribing patterns and cost of illness of Rheumatoid arthritis patients in two different hospitals. Methods: This is an observational study conducted in two different tertiary care hospitals in Salem district after obtaining approval of the Institutional Ethics Committee (IEC) (Registration Number EC/PHARM D/2019.06). A sample size of 102 (above 18 y) patients were included (52 from group 1 hospital and 50 from group 2 hospital). The study was conducted over a period of 6 mo from February 2019 to July 2019. The cost was collected by a patient face-to-face interview. Results: Out of 102 patients, females (57.84%) patients were more prevalent than men with the age group of 50-59 y in both groups. Methotrexate was most commonly prescribed drug in group 1(36.5%), whereas in group 2 are Sulfasalazine (37%). Among the DMARDs unit cost of methotrexate is high but the monthly cost was high for Sulfasalazine, because the methotrexate is prescribed on a once-weekly basis while sulfasalazine is taken twice a day. The cost of NSAIDs comes around 46.47% of the total drug cost of the month. In steroids, cost comes around 11.73% of the total drug cost. Among the direct cost of two groups, the drug cost and transportation cost is higher when compared with other costs. Indirect costs such as lost wages, due to disease is higher in group 1. Conclusion: The study concluded that the burden of RA to the patient is huge, Appropriate standard prescribing guidelines should be developed and implementation of the rational drug must be promoted. Polypharmacy was reported in group 1 hospital, the progression of symptoms was the same in both hospitals, it increases the cost of therapy and overall cost of patients. Hence it becomes vital to diagnose and control the disease at an early stage to control the economic burden on the patient.