POS1478-HPR ANALYSIS OF MEDICATION USAGE AND MONTHLY COSTS IN HOSPITALIZED PATIENTS WITH RHEUMATIC DISEASES: A RETROSPECTIVE OBSERVATIONAL STUDY
Authors: A. C. Bardan-Inchaustegui, D. A. Salcedo-Soto, P. Gamez-Siller, D. M. Lara-Mendez, D. E. Flores-Alvarado, J. A. Esquivel-Valerio, J. A. Cardenas-de la Garza, D. A. Galarza-Delgado
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Previous research has demonstrated that, from the patient's perspective, the costs associated with rheumatic diseases significantly affect a considerable portion of their income. This is particularly noteworthy given that the monthly income of northeastern Mexican families has been reported to be $708.71 USD [1]. The degree of medication adherence is intricately connected to overall health outcomes. Various socioeconomic risk factors have been identified as contributing to poor adherence, with elevated medication costs being a significant factor. The affordability of medication depends on whether it is covered by each specific healthcare system [2]. <h3>Objectives:</h3> To provide insights into medication utilization and associated costs, contributing to a better understanding of the economic aspects of rheumatic disease management. <h3>Methods:</h3> We conducted an observational retrospective analysis, focusing on the review of prescriptions provided to patients hospitalized for rheumatic diseases at the time of their discharge from our institution, Dr. José Eleuterio González University Hospital, located in Monterrey, Nuevo León, México. It is the only tertiary care facility in the northeastern region of the country for the population without social medical coverage. The study covered the period from March to December 2023. Medications prescribed at discharge were systematically categorized, as outlined in Table 1. Additionally, the average monthly expenses for DMARDs, immunosuppressants, biologics, and bisphosphonates were calculated using pricing data obtained from our institution's internal pharmacy. The total cost was reported in US dollars (USD), considering an equivalence of USD 1 = 16.89 Mexican pesos (MXN). <h3>Results:</h3> During the period from March to December 2023, there were 143 hospitalized patients. Prescriptions were obtained from 71 patients, with an average of 7 medications per prescription. Patients, on average, take 6 tablets a day. The most frequently prescribed category of medications was supplements in 68 prescriptions (95.77%), specifically Caltrate 600D+ (calcium carbonate/cholecalciferol). The second most frequently prescribed category of medications was steroids in 55 prescriptions (77.46%), mainly prednisone in its 5 mg presentation. The third most frequently prescribed category of medications was the conventional synthetic DMARD category in 54 prescriptions (76.05%), primarily hydroxychloroquine followed by methotrexate, leflunomide, sulfasalazine, and chloroquine. Nine prescriptions included &gt;2 synthetic DMARDs. The average expenditure for this category was $ 110.69 USD monthly. The average expenditure for immunosuppressants was $ 395.29 USD. The average expenditure for bisphosphonates was $ 118.36 USD. <b>Table 1.</b> Categories and Frequency of Medications Prescribed at Discharge for Hospitalized Patients with Rheumatic Diseases (*) Denotes the most frequently prescribed medication in each group. <h3>Conclusion:</h3> The high average number of medications per prescription indicates the complexity of the treatment regimens. The economic aspects highlight potential challenges faced by patients in accessing and affording necessary medications, pointing towards areas where healthcare support or interventions may be beneficial. <h3>REFERENCES:</h3> [1] Skinner-Taylor C, Perez-Barbosa L, et al. The economic burden of prenatal care for women with rheumatic diseases: a cross-selectional study from a university hospital. Clin Rheumatol. 2023 Sep;42(9):2521-2523. doi: 10.1007/s10067-023-06713-6. [2] Gil-Guillen, V.F.; Balsa, A.; Bernárdez, B. et al. Medication Non-Adherence in Rheumatology, Oncology and Cardiology: A Review of the Literature of Risk Factors and Potential Interventions. Int. J. Environ. Res. Public Health 2022, 19, 12036. https://doi.org/10.3390/ ijerph191912036 <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>