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Treatment of rheumatoid arthritis in the Brazilian Unified National Health System: expenditures on infliximab compared to synthetic disease-modifying anti-rheumatic drugs, 2003-2006

This study aimed to characterize the profile of users and related expenses with infliximab and synthetic disease-modifying anti-rheumatic drugs (DMARD) for rheumatoid arthritis treatment in the Brazilian Unified National Health System (SUS). We constructed a cohort from 2003 to 2006 drawing on databases of the SUS Outpatient Information System. Analyses were stratified by clinical and socio-demographic characteristics. We calculated average monthly expenditure per individual follow-up year and the factors that influenced it. The cohort consisted of 26,228 patients, mostly female, between 40 and 59 years of age, living in the Southeast of Brazil, and diagnosed with Felty's syndrome. Medicines for rheumatoid arthritis totalized BRL 74,306,087.18, of which infliximab accounted for 70%. Median monthly per capita expenditure was BRL 3,466.03 for patients receiving infliximab compared to BRL 143.85 for patients treated with synthetic DMARD. Drug treatment for rheumatoid arthritis was the main expense in SUS, with high economic impact from infliximab. Sex, diagnosis, age, and region of residence were factors that influenced expenditures.

Rheumatoid Arthritis; Health Expenditures; Unified Health System

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