Comprehensive Insights into the Economic Burden of Rheumatoid Arthritis in Latin America: A Systematic Literature Review of Regional Perspectives.

Abstract

Purpose: Rheumatoid arthritis (RA) affects approximately 0.3 to 1.2% of the world's population. The objective of this study was to identify the existing literature on economic evaluations of RA in Latin America.

Patients and methods: Studies of economic evaluations of patients with RA from 2000 to 2023 were analyzed using the databases PubMed, Scopus, Web of Science, Embase, Cochrane, and the Virtual Health Library following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Study quality was assessed using the Joanna Briggs Institute (JBI) tool, and qualitative analysis was done (following SwiM guidelines).

Results: A total of 851 articles were identified. Following the application of inclusion criteria to titles and abstracts, 117 articles were initially considered eligible. Of these, 42 were excluded due to population or outcome-based errors, leaving 27 articles and 48 abstracts for analysis. Duplicates were removed prior to this process. The included studies involved various designs: cross-sectional, longitudinal, prospective, and retrospective. Brazil accounted for the highest proportion of publications (33.3%), followed by Colombia and Mexico, each contributing 26%. Most economic studies focused on cost analysis (86%), while cost-effectiveness studies and cost-utility studies represented 7.4% and 3.3%, respectively. Predominant perspectives included third-party payer 26%, insurers 14.8%, social providers 7.4%, and mixed providers 3.7%. In terms of publications of abstracts, Colombia leaded at 35.4%. The predominant perspective was that of the provider 66.6%, including the general perspective (37.5%), private (34.3%), public (22%), and mixed (6.2%) and the perspective of third-party payers (33.3%).

Conclusion: Economic evaluations of rheumatoid arthritis in Latin America remain limited, with most studies focusing on cost analysis. Brazil, Colombia, and Mexico lead in publications, primarily from a provider perspective. Greater emphasis on cost-effectiveness and broader economic evaluations is needed to guide health policy in the region.