How much do rheumatologists and orthopaedists doctors’ modalities impact the cost of arthritis in Cyprus?

BACKGROUND Osteoarthritis is one of the primary causes of long-term functional disability. With an estimated 13.5% prevalence in the general population contributes to a significant financial burden both for patients and healthcare systems. The purpose of this research is to highlight the direct annual cost of the disease to the private healthcare sector of Nicosia. METHODS A questionnaire based on Greek and international research was completed between 10/1/2012 and 11/30/2012, with a sample of 20 doctors specialists in orthopaedics and rheumatology (50% of practising physicians in the private sector). An assessment of the annual cost of medical procedures and tests, pharmacologic therapies (modalities) and supplies per patient followed, based on current costs. Direct costs were assessed through the micro-costing "bottom-up" approach. We isolated and separately priced the original diagnosis, followed by each stage of the disease. RESULTS The cost for the six predominant medical tests to establish a diagnosis and exclude mainly RA such as ESR, CPR, and X-ray as well as a physician's office visit was 150€ per patient. The average direct cost per patient during stages 1, 2 and 3 of the disease was 280.54€, 1,834.64€ and 5,641.72€ annually, respectively, with an annual average of 2,573€ per patient. CONCLUSIONS Even though during the period of the study, the country had not yet established clinical guidelines, the participating physicians followed international practices. Significant rise in the cost in each stage of the disease was found, with additional increases in the following years as a result of the expected increased prevalence of the disease. It is noted here that uninsured patients, as well as those who qualified for free medical care, they seek these services in the private sector, and had to pay out of pocket money for examination and treatment. These patients, thus, contended with a serious financial burden. Therefore, it is important to inform them very extensively regarding evidence-based management of the disease to aid them in coping with this chronic illness.