Rheumatoid arthritis (RA) is a heterogeneous, systemic and autoimmune disease with symmetric polyarthritis. Patients have a higher incidence of disability and functional limitations with a longer course. RA not only causes a decline in patients' physical function, quality of life and social participation, but also imposes a huge economic burden on patients' families and society. This study was to explore the disease burden of RA in China.


      The disease burden model was built in Microsoft Excel 2016 and the economic burden of disease was categorized into direct medical, direct non-medical, and indirect costs. Treatment pattern, quality of life, epidemiological and cost data were extracted from a systematic review of literature and public databases, real world data from Hospital Pharmacy Committee of Chinese Pharmaceutical Association were also included in analyses. Data synthesized were examined and the data-gaps were filled by in-depth interviews with clinical and health economic experts, and by advisory board meetings (Delphi Panel). One-way sensitivity analyses of key parameters were also conducted.


      In China, the prevalence of RA is about 0.41%. According to the calculations, the annual total cost of RA in China in 2018 was about ¥12,673,622,280 RMB, among which direct medical cost accounts for 33.3%, direct non-medical cost accounts for 29.8%, and indirect cost accounts for 37.0%.


      The indirect costs are high in current RA management as the effective treatment for RA is insufficient in China, leads to a heavy societal burden due to productivity loss caused by consequential deformity and disability. In order to improve the outcomes and quality of life of RA patients, it is needed to improve the awareness of the disease in patients and physicians, to facilitate the coverage of biological agents by reimbursement list, and to follow the standardized clinical treatment pathways for management of RA.