Evolution of direct and indirect costs of chronic systemic auto-immune and inflammatory rheumatic diseases in France: a 2015–2023 nationwide population-based study
- 1Department of Rheumatology, INSERM UMR-S 1109, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- 2Centre National de Référence des Maladies Auto-immunes (RESO), Strasbourg, France
- 3Sorbonne Université, CIMI, INSERM U1135, Faculté de médecine, AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France
Abstract
Background Chronic systemic auto-immune and inflammatory rheumatic diseases (SAIIRDs) are associated with substantial healthcare utilisation and productivity loss. Recent advances in their management may have modified their economic burden. Our aim was to describe changes in both direct and indirect costs of SAIIRDs in France, using nationwide data.Methods We conducted a population-based study using the National Health Data System, covering nearly the entire French population from 2015 to 2023 (≈67.3 million individuals in 2023). Annual reimbursed expenditures for SAIIRDs, including direct medical costs (hospitalisations, outpatient care, medications) and indirect costs (daily allowances, disability benefits, annuities) were analysed.Results The total number of patients with SAIIRDs increased by 30% between 2015 and 2023, from 191 450 to 249 120 while total reimbursed expenditures increased more sharply, from €388.4 million in 2015 to €628.5 million in 2023 (+61.8%), with an increase in the mean annual cost per patient (from €2029 to €2523). Outpatient care was the most prominent component of healthcare expenditures for SAIIRDs, with medication costs increasing more rapidly than total expenditures (+98.9% vs +61.8%), identifying medications as the main driver of cost increase for SAIIRDs. Hospital-based care showed a more moderate growth over time. In parallel, reimbursed cash benefits (indirect costs) increased by 74.4% (€58 million to €101 million, twofold more than the general population), highlighting the major indirect burden of SAIIRDs.Conclusion Between 2015 and 2023, healthcare expenditures associated with SAIIRDs in France increased substantially. Further work should focus on the contribution of comorbidities and associated health conditions.
Related
- COVID-19 severity and early inflammatory biomarkers in patients with immune-mediated inflammatory rheumatic diseases: a multicenter cohort study
- Trends in rheumatic heart disease mortality in the United States of America from 1968 to 2023: a nationwide analysis
- Comorbidity management in inflammatory rheumatic diseases: a dual-perspective survey of patients and rheumatologists.
- Knowledge, attitude and practice of patients with immune-mediated and inflammatory rheumatic diseases towards mental health and psychological interventions
- Global mortality trends of inflammatory rheumatic diseases between 2000 and 2019
BibTeX
@article{arnaud2026evolution,
title = {{Evolution of direct and indirect costs of chronic systemic auto-immune and inflammatory rheumatic diseases in France: a 2015–2023 nationwide population-based study}},
author = {Laurent Arnaud and Thierry Martin and François Chasset and Mathilde Richard},
journal = {RMD Open},
year = {2026},
month = nov,
doi = {10.1136/rmdopen-2026-007394},
url = {https://doi.org/10.1136/rmdopen-2026-007394},
note = {CC BY},
}
RIS
TY - JOUR
TI - Evolution of direct and indirect costs of chronic systemic auto-immune and inflammatory rheumatic diseases in France: a 2015–2023 nationwide population-based study
AU - Laurent Arnaud
AU - Thierry Martin
AU - François Chasset
AU - Mathilde Richard
PY - 2026
DA - 2026/11/08
JO - RMD Open
DO - 10.1136/rmdopen-2026-007394
UR - https://doi.org/10.1136/rmdopen-2026-007394
AB - Background Chronic systemic auto-immune and inflammatory rheumatic diseases (SAIIRDs) are associated with substantial healthcare utilisation and productivity loss. Recent advances in their management may have modified their economic burden. Our aim was to describe changes in both direct and indirect costs of SAIIRDs in France, using nationwide data.Methods We conducted a population-based study using the National Health Data System, covering nearly the entire French population from 2015 to 2023 (≈67.3 million individuals in 2023). Annual reimbursed expenditures for SAIIRDs, including direct medical costs (hospitalisations, outpatient care, medications) and indirect costs (daily allowances, disability benefits, annuities) were analysed.Results The total number of patients with SAIIRDs increased by 30% between 2015 and 2023, from 191 450 to 249 120 while total reimbursed expenditures increased more sharply, from €388.4 million in 2015 to €628.5 million in 2023 (+61.8%), with an increase in the mean annual cost per patient (from €2029 to €2523). Outpatient care was the most prominent component of healthcare expenditures for SAIIRDs, with medication costs increasing more rapidly than total expenditures (+98.9% vs +61.8%), identifying medications as the main driver of cost increase for SAIIRDs. Hospital-based care showed a more moderate growth over time. In parallel, reimbursed cash benefits (indirect costs) increased by 74.4% (€58 million to €101 million, twofold more than the general population), highlighting the major indirect burden of SAIIRDs.Conclusion Between 2015 and 2023, healthcare expenditures associated with SAIIRDs in France increased substantially. Further work should focus on the contribution of comorbidities and associated health conditions.
SN - 2056-5933
ER -