Direct medical costs of polyarthritis in a pediatric hospital in Mexico

María F. Carrillo-Vega, Dirección de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico
Juan M. Mireles-Dorantes, Centro de Estudios Económicos y Sociales en Salud, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
Samara Mendienta-Zerón, Servicio de Reumatología Pediátrica, Hospital Materno Infantil, Instituto de Seguridad Social de Estado de México y Municipios, Toluca, State of Mexico, Mexico
Guillermo Salinas-Escudero, Centro de Estudios Económicos y Sociales en Salud, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
Filiberto Toledano-Toledano, Unidad de Medicina Basada en la Evidencia, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
Victor Granados-García, Unidad de Investigación en Epidemiología y Servicios de Salud, Área de Envejecimiento, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico

Background: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children. The polyarticular course (polyarthritis) represents 63-66% of patients with JIA. The aim was to determine the direct medical costs (DMC) of JIA of the polyarthritis type in pediatric patients of a tertiary hospital in Mexico. Methods: An analysis of the disease costs was developed from the perspective of the Instituto de Seguridad Social del Estado de México y Municipios Maternal and Child Hospital (HMI). The time horizon was 12 years. All patients diagnosed with JIA with polyarticular course treated by the pediatric rheumatology service of the HMI from January to September 2022 and with an active clinical record were included. Different costing techniques were used. The cost components were consultations, medications, hospitalization, and office and laboratory studies. The costs are reported in USD 2021. Results: Twenty-six records of patients with polyarticular arthritis from the HMI were analyzed, with a mean of 4,555.2 USD (standard deviation [SD] = 1,456.7) and a median of 3,828 USD (SD = 1,492) in the first 10 years of treatment. The components of DMC were medications (82.7%), office and laboratory studies (8.4%), hospitalization (8.0%), and consultations (1.8%). Biological disease-modifying drugs (bDMARDs) accounted for 95.3% of the drug component cost. Conclusion: The cost of bDMARDs represented the most critical cost of polyarticular JIA, reflected in the 2nd year of treatment. Including generic bDMARDs and reviewing purchase prices by health institutions in Mexico is necessary.

Keywords: Direct medical costs. Polyarthritis. Mexico. Juvenile idiopathic arthritis.