{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T15:16:53Z","timestamp":1779895013475,"version":"3.53.1"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004320","name":"Shiraz University of Medical Sciences","doi-asserted-by":"publisher","award":["97\u201001\u201007\u201018106"],"award-info":[{"award-number":["97\u201001\u201007\u201018106"]}],"id":[{"id":"10.13039\/501100004320","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Challenges"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rheumatoid arthritis (RA) is a progressive and chronic systemic inflammatory disease and imposes a significant economic burden on patients and societies if not controlled. This study aimed to determine the economic burden of RA in Iran in 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This economic burden study was carried out as cross\u2010sectional research in 2022, in which 765 patients referred to the medical centers affiliated with Shiraz University of Medical Sciences in Fars province were included through census. The prevalence\u2010based and bottom\u2010up approaches were also used, respectively, to prepare the cost information and calculate the costs from the societal perspective. The human capital approach was used to calculate the indirect costs as well. The Excel 2016 software was used for data analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results showed that the economic burden of RA in Iran was $6388.64 per patient\u2010year in 2022. In addition, the mean annual costs of RA per patient in remission, low, and moderate\u2010to\u2010severe states were, respectively, $6268.24, $6248.00, and $6729.43 in 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RA imposed a significant economic burden on the community and patients, and direct medical costs (DMCs), especially the cost of medicines, were the most important component. It is suggested to provide necessary facilities to produce RA medicines in the country and expand the home care services in order to reduce the economic burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/puh2.70131","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T15:46:49Z","timestamp":1762962409000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Economic Burden of Rheumatoid Arthritis in Iran: A Societal Perspective"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2241-4402","authenticated-orcid":false,"given":"Mehdi","family":"Rezaee","sequence":"first","affiliation":[{"name":"Department of Management, Economics and Health Policy, School of Health Bushehr University of Medical Sciences  Bushehr Iran"},{"name":"Student Research Committee, School of Health Management and Information Sciences Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farhad","family":"Lotfi","sequence":"additional","affiliation":[{"name":"Health Human Resources Research Center, School of Health Management and Information Sciences Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Gholami","sequence":"additional","affiliation":[{"name":"Biotchnology Research Center Shiraz University of Medical Sciences  Shiraz Iran"},{"name":"Department of Pharmaceutical Biotechnology, School of Pharmacy Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jassem","family":"Azizpoor","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Biotechnology, School of Pharmacy Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elham","family":"Aflaki","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, School of Medicine Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afsaneh","family":"Vazin","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khosro","family":"Keshavarz","sequence":"additional","affiliation":[{"name":"Health Human Resources Research Center, School of Health Management and Information Sciences Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60826-4"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2012.11.009"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph121113807"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050312117713647"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-76511-6"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/14397595.2019.1682776"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.5114\/aoms.2017.71371"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-020-04731-0"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.12809"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-014-0174-6"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10198-007-0088-8"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1185\/03007990903422307"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39079"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204311"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci18-0007"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-199813010-00001"},{"key":"e_1_2_13_18_1","unstructured":"Ministry of Cooperatives Labor and Social Welfare \u2013 Islamic Republic of Iran Details of Workers' Wages in 2022 accessed April 12 2023 https:\/\/alborz.mcls.gov.ir\/fa\/news\/236599."},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(84)90118-1"},{"key":"e_1_2_13_20_1","unstructured":"\u201cExchange Rate \u201dCentral Bank of the Islamic Republic of Iran accessed June 18 2021 https:\/\/www.cbi.ir\/default_en.aspx."},{"key":"e_1_2_13_21_1","unstructured":"Statistical Center of Iran Population and Housing Censuses accessed March 28 2023 http:\/\/www.amar.org.ir."},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2018.11.001"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211555"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-216243"},{"key":"e_1_2_13_25_1","unstructured":"CCEMG\u2010EPPI Centre Cost Converter accessed September 8 2022 https:\/\/eppi.ioe.ac.uk\/costconversion\/."},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40261-016-0491-y"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.14295"},{"key":"e_1_2_13_28_1","unstructured":"\u201cGDP PPP (Current International $)\u2014Iran Islamic Rep \u201dWorld Bank Accessed October 4 2021 https:\/\/data.worldbank.org\/indicator\/NY.GDP.MKTP.PP.CD?locations=IR."},{"key":"e_1_2_13_29_1","unstructured":"\u201cCurrent Health Expenditure (% of GDP)\u2014Iran Islamic Rep \u201dWorld Bank accessed October 4 2021 https:\/\/data.worldbank.org\/indicator\/SH.XPD.CHEX.GD.ZS?locations=IR."},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/09733698241239709"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2020.08.1145"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.13028"},{"issue":"2","key":"e_1_2_13_33_1","first-page":"202","article-title":"The Cost of Care of Rheumatoid Arthritis and Ankylosing Spondylitis Patients in Tertiary Care Rheumatology Units in Turkey","volume":"30","author":"Malhan S.","year":"2012","journal-title":"Clinical and Experimental Rheumatology"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.62.6.544"},{"issue":"6","key":"e_1_2_13_35_1","first-page":"1033","article-title":"Direct and Indirect Healthcare Costs of Rheumatoid Arthritis Patients in Turkey","volume":"34","author":"Hamuryudan V.","year":"2016","journal-title":"Clinical and Experimental Rheumatology"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.11439"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.13776"},{"key":"e_1_2_13_38_1","first-page":"219","article-title":"Cost of Rheumatoid Arthritis in a Selected Population From Argentina in the Prebiologic Therapy Era","volume":"4","author":"Catay E.","year":"2012","journal-title":"ClinicoEconomics and Outcomes Research"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vhri.2023.10.001"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22160"},{"issue":"1","key":"e_1_2_13_41_1","first-page":"57","article-title":"The Economic Burden of Rheumatoid Arthritis in a Developing Nation: Results From a One\u2010Year Prospective Cohort Study in Thailand","volume":"34","author":"Osiri M.","year":"2007","journal-title":"Journal of Rheumatology"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker014"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq399"}],"container-title":["Public Health Challenges"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/puh2.70131","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T05:33:10Z","timestamp":1766986390000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/puh2.70131"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,12]]},"references-count":42,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/puh2.70131"],"URL":"https:\/\/doi.org\/10.1002\/puh2.70131","archive":["Portico"],"relation":{},"ISSN":["2769-2450","2769-2450"],"issn-type":[{"value":"2769-2450","type":"print"},{"value":"2769-2450","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,12]]},"assertion":[{"value":"2024-06-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70131"}}