AB0760 EVALUATING THE ECONOMIC BURDEN OF RHEUMATOID ARTHRITIS IN LATIN AMERICA: A SYSTEMATIC LITERATURE REVIEW
Authors: A. I. Maldonado-Restrepo, G. S. Rodríguez-Vargas, G. E. Acelas-Gonzalez, P. Rodríguez-Linares, J. L. Gonzalez-Rodriguez, A. Rojas-Villarraga, P. Santos-Moreno
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis (RA) is a chronic, autoimmune disease that generates a high economic impact on healthcare systems due to morbimortality and occupational disability. It is crucial to identify the macroeconomic impact of the disease in Latin America in order to manage and control the costs it generates. <h3>Objectives:</h3> The aim of the study is to conduct a systematic literature review identifying the available health literature on the economic evaluation of RA in Latin America. <h3>Methods:</h3> Published studies on economic evaluations in patients RA from the period 2000 to 2023 were included and analyzed. The databases of PubMed, Scopus, Web of Science, Embase, Cochrane, and the Virtual Health Library were consulted. PRISMA method was followed to fulfill the standards of the systematic review. The evaluation process involved four reviewers, and any inconsistencies were resolved by a third reviewer. The quality of the studies was assessed using "<i>Joanna Briggs Institute tool</i> (JBI)". A qualitative analysis was done following the synthesis without meta-analysis guideline. <h3>Results:</h3> Initially, 823 articles were identified, and duplicates were removed. Inclusion criteria were applied to titles and abstracts, resulting in 114 articles meeting the criteria. Among these, 42 were excluded due to errors related to population or outcome. Ultimately, 24 articles and 48 abstracts were included in the analysis (Figure 1). The results of the evaluation by means of the JBI tool by the reviewers evidenced a mean difference of -0.5 with a standard deviation of 1.38 without significant differences which indicates that the ratings of the different reviewers tend to be grouped close to the mean. The years in which major publications were reported were 2008, 2011 and 2021. The age range of the population in which the studies were conducted was 45 - 60 years. In relation to gender, the highest frequency of articles corresponds to women. Regarding the design of the studies: cross-sectional, longitudinal, prospective and retrospective studies were found. Brazil leads in article publications with 34.5%, followed by Colombia at 29%, and Mexico at 26%. The primary focus of economic studies was on cost analysis, accounting for 87.5%, while cost-effectiveness and cost-utility constitute 8.3% and 4.2%, respectively. The predominant perspectives adopted include the third-party payer (representing international insurance companies that provide coverage and cover economic expenses during the disease process) at 29%, insurers at 13%, social at 8%, and mixed providers at 4%. A collaborative study between Brazil, Mexico, Colombia, and Argentina demonstrated net cost savings among rheumatoid arthritis (RA) patients for biologics from 2012 to 2022, resulting in net cost savings by 2023 for each country: $5.089 billion Argentinean pesos, $8.286 billion Brazilian reals, $3.482 billion Colombian pesos, and $3.789 billion Mexican pesos. Regarding abstract publications, Colombia takes the lead with 35.4%, followed by Brazil at 17%, and Mexico at 10.4%, with the remaining countries contributing 37.2%. The most prevalent perspective is that of the provider at 66.6%, general perspective (37.5%), private (34.3%), public (22%), and mixed (6.2%). This is followed by the third-party payer perspective, accounting for 33.3%. <h3>Conclusion:</h3> Cost assessment in RA Latin American patients emphasizes the need for careful expense management by insurers and healthcare providers, highlighting the importance of robust health policies and risk management in global systems. Definitively more research is needed regarding Latin American RA population. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Angela Isabel Maldonado-Restrepo: None declared, Gabriel-Santiago Rodríguez-Vargas: None declared, Gabriel E. Acelas-Gonzalez: None declared, Pedro Rodríguez-Linares: None declared, Javier-Leonardo Gonzalez-Rodriguez: None declared, Adriana Rojas-Villarraga: None declared, Pedro Santos-Moreno Abbvie, Abbott, Biopas-UCB, Bristol, Janssen, Pfizer, Roche, Sanofi, Abbvie, Abbott, Biopas-UCB, Bristol, Janssen, Pfizer, Roche, Sanofi.