LAUSR

Background Biological disease-modifying anti-rheumatic drugs (bDMARDs) are effective but expensive treatment options in juvenile idiopathic arthritis (JIA). The extent to which the healthcare costs of JIA have changed as a result of their increasing use has hardly been investigated. Objectives The aim of this study was to analyse resource utilisation and direct healthcare costs in patients with JIA since the introduction of treatment with biologic agents. Methods Using health insurance claims data in Germany, resource utilisation and direct healthcare costs of children and adolescents with a diagnosis of JIA (International Classification of Diseases, Tenth Revision, [ICD-10] code M08, M09.0, L40.5) between January 1, 2007 and December 31, 2016 were assessed. Direct healthcare costs comprised costs for outpatient care (i.e., visits to physicians, laboratory tests, emergency department visits, and outpatient hospital services), costs for inpatient care (i.e., hospital admissions), costs for pharmacotherapy and other treatment costs (i.e., non-physician visits [e.g., visits to physical therapists] and aids/adaptations). Results Data from 12 652 children and adolescents with a diagnosis of JIA were included in the analyses. Mean direct healthcare costs per patient increased by 33% from € 4577 in 2007 to € 6109 in 2016. Pharmacological treatment was the cost domain with the highest increase (table 1). This increase was almost entirely caused by an increasing prescription of bDMARDs (from 8.6% to 15.7%). Costs for inpatient care also increased, whereas other treatment costs slightly decreased. Total costs per patient were calculated as the sum of the domains outpatient care, hospital admissions, pharmacotherapy and other treatment costs. bDMARDs, biological Disease-Modifying Anti-Rheumatic Drugs; csDMARDs, conventional synthetic Disease-Modifying Anti-Rheumatic Drugs. * excluding costs for pharmacotherapy. Conclusions Direct healthcare costs in JIA considerably increased over the past 10 years, mainly caused by an expanding use of biologic agents. The results also showed that the rise in costs for treatment with biologic agents has been at a plateau since 2014. The healthcare costs incurred must, of course, always be placed in the context of indirect and intangible costs and the long-term prognosis of patients. Acknowledgements This work was supported by the Federal Ministry of Education and Research within the research network PROCLAIR (01EC1405). Disclosure of Interest None declared