Drug Utilization Pattern and Cost Analysis in Rheumatoid Arthritis Patients – A Cross–Sectional Study in Tertiary Care Hospital, Mumbai

Aims: To study the current prescription pattern and to analyze the cost of the treatment Prescribed to RA patients referred to rheumatology OPD in KEM hospital.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Medicine and Department of Pharmacology, Seth GSMC & KEM Hospital, between July 2011 and December 2011.
Methodology: The study protocol was approved by the institutional ethics committee. Patients attending Rheumatology OPD for existing RA disease were recruited as per inclusion criteria. Written informed consent was sought. It was a cross-sectional study. Total 100 consecutive rheumatoid arthritis patients (fulfilling the American College of Rheumatology Criteria 1987) were recruited from 1st July to 1st September 2011.
Results: Majority of patients (67%) in the study population were on combination of two DMARDs. Most frequently prescribed two DMARDs combination was methotrexate and hydroxychloroquine (64%). Average total cost per prescription was found to be 763.39 Indian rupees (US$ 14), while average hospital and out of pocket expense were 281.12 Indian rupees (US$ 5) and 482.88 Indian rupees (US$ 9) respectively.
Conclusion: The drug use pattern in RA was found to be DMARDs based and majority of the cost was borne by the patient. The total cost increased was due to administration of drugs to treat the adverse drug reaction. Prospective studies in a larger number of patients are needed to assess the utility of prescription audit and cost analysis of drugs used in RA.