# Medical costs for patients with rheumatoid arthritis who have comorbid diabetes mellitus

## TL;DR

Patients with rheumatoid arthritis and diabetes had higher medical costs due to more use of biological treatments.

## Contribution

This study quantifies increased medical costs in RA patients with comorbid diabetes in Japan.

## Key findings

- RA patients with diabetes had significantly higher total medical costs compared to those without diabetes.
- Drug costs were higher in the diabetes group due to increased use of biological DMARDs.
- Treatment and material costs were similar between the two groups.

## Abstract

To evaluate medical costs and resource use in patients with rheumatoid arthritis (RA) with and without diabetes mellitus (DM).

Data were obtained from the Japan Medical Data Center (JMDC) claims database. The baseline period comprised 6 months before the index date (first prescription date post-RA diagnosis) while the 12-month duration post-index date was the follow-up period. Patients with RA and DM prescribed an antidiabetic drug in the baseline period constituted the DM group, while patients with RA without DM or an antidiabetic prescription in the baseline and follow-up periods belonged to the non-DM group. Patients were matched by sex, age, Charlson Comorbidity Index (CCI), months from the first RA codes, and medications. The primary endpoint was total medical costs per patient in the follow-up period. The secondary endpoints were costs for drugs, treatments, and materials, their sub-categories, and proportions of patients using the sub-categories.

One hundred and sixty-one DM group patients and 2,974 non-DM group patients were eligible for inclusion, and 109 patients were matched from each group. The median values of age and CCI were 59 years and 2.0 in both groups. After excluding DM-specific costs, both total medical costs and drug costs were significantly higher in the DM group compared with the non-DM group (total medical costs: DM/ non-DM: 5,163 USD/ 3,782 USD, P < 0.05; drug costs: DM/ non-DM: 2,242 USD/ 1,066 USD, P < 0.05) because of a higher proportion of biological disease-modifying antirheumatic drug (DMARD) users in the DM group (DM/ non-DM: 14.7%/ 5.5%). Treatment costs and material costs did not differ between the two groups.

Medical costs for RA were higher in the DM group than in the non-DM group because of a higher proportion of biological DMARD users.