{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:02:08Z","timestamp":1785304928915,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T00:00:00Z","timestamp":1763769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T00:00:00Z","timestamp":1763769600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this systematic review was to synthesize the economic impact of rheumatoid arthritis (RA) on households, health systems, and society in low\u2010 and middle\u2010income countries (LMICs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Electronic databases such as PubMed, Web of Science, and CINAHL were searched using keywords related to RA and cost of illness. Eligible studies were required to report RA\u2010related costs, be conducted in LMICs, and be published in English. Quality appraisal of the included studies was conducted using the Newcastle\u2013Ottawa Scale for cohort studies. A narrative synthesis and meta\u2010analysis of findings was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 5,134 studies was initially identified for screening. After removing 1,028 duplicates, 50 studies were selected for full\u2010text review, and 15 met the eligibility criteria and were therefore included in the review. These studies, published between 2007 and 2024, were conducted in various countries, including Turkey (n = 3), China (n = 2), and one study each from Thailand, Hungary, Mexico, Colombia, Morocco, Pakistan, India, Romania, Brazil, and Argentina. Nine studies adopted a societal perspective, whereas six used a health care perspective. The total sample size was 218,575 participants, with individual study sizes ranged from 62 to 209,292. Average annual direct costs per patient ranged from US$523 to US$2,837.90, and indirect costs ranged from US$81.80 to US$2,463.40. The pooled average annual costs for outpatients, inpatients, and medical costs were US$517.72 (95% confidence interval [CI] $3.35\u2013$1,032.09), US$543.88 (95% CI US$499.51\u2013US$588.24), and US$3,379.83 (95% CI US$3,137.58\u2013US$3,622.08), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RA poses a significant economic challenge in LMICs, where limited health care resources and high treatment costs make care unaffordable for many. This review uniquely underscores that enhancing treatment access and optimizing resource use can reduce both medical and productivity losses, improving patient outcomes and strengthening economic resilience.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.25627","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T06:22:03Z","timestamp":1755584523000},"page":"325-336","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Economic Burden of Rheumatoid Arthritis in Low\u2010 and Middle\u2010Income Countries: Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7976-2013","authenticated-orcid":false,"given":"Tadesse","family":"Gebrye","sequence":"first","affiliation":[{"name":"Manchester Metropolitan University  Manchester United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chidozie E.","family":"Mbada","sequence":"additional","affiliation":[{"name":"Manchester Metropolitan University  Manchester United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara T.","family":"Fatoye","sequence":"additional","affiliation":[{"name":"Manchester Metropolitan University  Manchester United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faatihah","family":"Niyi\u2010Odumosu","sequence":"additional","affiliation":[{"name":"University of the West of England  Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ushotanefe","family":"Useh","sequence":"additional","affiliation":[{"name":"North\u2010West University  Potchefstroom South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zalmai","family":"Hakimi","sequence":"additional","affiliation":[{"name":"Swedish Orphan Biovitrum AB  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Fatoye","sequence":"additional","affiliation":[{"name":"North\u2010West University  Potchefstroom South Africa"},{"name":"Manchester Metropolitan University, Manchester, United Kingdom, and North\u2010West University  Potchefstroom South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,22]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Ramipril","author":"Chauhan K","year":"2024"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000493390"},{"issue":"10","key":"e_1_2_6_4_1","first-page":"591","article-title":"Global epidemiology of rheumatoid arthritis","volume":"18","author":"Finckh A","year":"2022","journal-title":"Nat Rev Rheumatol"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-010-1637-6"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/39.1.28"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(02)00597-3"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2016.1161187"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5516"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2016.02.017"},{"issue":"1","key":"e_1_2_6_11_1","article-title":"Global Health Epidemiology Reference Group. 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