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. 2021 Jun 16:13:519-529.
doi: 10.2147/CEOR.S302404. eCollection 2021.

Quantifying Potential Cost-Savings Through an Alternative Imaging-Based Diagnostic Process in Presumptive Seronegative Rheumatoid Arthritis

Pedro Santos-Moreno  1 , Nelson J Alvis-Zakzuk  2 , Edwin Castillo  1 , Laura Villarreal  1 , Carlos Pineda  3 , Hugo Sandoval  4 , Omaira Valencia  1   5
Affiliations

Quantifying Potential Cost-Savings Through an Alternative Imaging-Based Diagnostic Process in Presumptive Seronegative Rheumatoid Arthritis

Pedro Santos-Moreno et al. Clinicoecon Outcomes Res. .

Abstract

Background: Seronegative rheumatoid arthritis (SRA) is a condition that is not well understood and difficult to confirm by a conventional diagnostic process. We aimed to quantify the potential cost-savings of an alternative diagnostic process (ADP) imaging-based, for patients with presumptive SRA from everyday clinical practice.

Methods: We performed a retrospective analysis for patients with presumptive SRA who tested negative for both rheumatoid factor and anti-cyclic citrullinated peptide antibodies, through an ADP imaging-based, that is a standard clinical practice in our center. After we confirmed the diagnosis of SRA or reclassified patients in terms of another proper diagnosis, we estimate direct costs in two scenarios: a conventional and ADP. We compared the cost of RA treatment during the first year against the cost of the most misdiagnosed treatment (osteoarthritis) found after applying the ADP to determine potential cost-savings.

Results: We included 440 patients with a presumptive diagnosis of SRA. According to the imaging-based ADP, SRA was confirmed in 106/440 (24.1%), unspecified RA in 9/440 (2.0%), and osteoarthritis in 325/440 (73.9%) of those patients. Although the costs of conventional diagnosis per patient is lower than those of ADP ($59,20 USD vs $269,57 USD), we found a potential drug cost-savings of $1,570,775.20 US Dollars after 1 year of correct treatment.

Conclusion: An alternative diagnosis process, including X-rays, US and MRI imaging, and clinical and blood-test assessment, not only increased diagnostic certainty in patients referred for evaluation of presumptive SRA but also suggested a potential cost-savings in pharmacological treatments avoided in misdiagnosed patients.

Keywords: cost-savings; diagnosis; imaging; seronegative rheumatoid arthritis.

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Conflict of interest statement

Dr Pedro Santos-Moreno reports non-financial support from Abbvie, Bristol, Biopas-UCB, Roche, Sanofi, grants, personal fees from Pfizer, during the conduct of the study. The authors declare that they have no other competing interests.

Figures

Figure 1
Figure 1
Alternative Diagnosis process (ADP): Diagram describing the diagnosis and the number of patients according to the point-in-process classification.
See this image and copyright information in PMC

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