{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T15:47:55Z","timestamp":1780415275046,"version":"3.54.1"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chinese National Key Technology R&D Program, Ministry of Science and Technology","award":["2022YFC2504600;2022YFC3601800"],"award-info":[{"award-number":["2022YFC2504600;2022YFC3601800"]}]},{"name":"CAMS Innovation Fund for Medical Sciences","award":["2021-I2M-1-005, 2022-I2M-1-004, 2023-I2M-2-005"],"award-info":[{"award-number":["2021-I2M-1-005, 2022-I2M-1-004, 2023-I2M-2-005"]}]},{"name":"The Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences","award":["2021-PT320-002, 2019-PT330-004"],"award-info":[{"award-number":["2021-PT320-002, 2019-PT330-004"]}]},{"name":"National High Level Hospital Clinical Research Funding","award":["2022-PUMCH-B-013"],"award-info":[{"award-number":["2022-PUMCH-B-013"]}]},{"name":"The Special Science Research for Health Development in Capital","award":["No.2024-1G-2082"],"award-info":[{"award-number":["No.2024-1G-2082"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To date, the evidences of economic burden for the RA individual in the real-world clinical practice were still limited in China. This study aimed to estimate average annual costs of rheumatoid arthritis (RA) patients using inverse probability weighting (IPW) and their influence factors.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A multicenter, cross-sectional study was conducted and the RA patients who met inclusion criteria on CREDIT cohort were invited to participate the survey. After they signed the informed confirm form, the information of outpatient and inpatient expenditures in the past year were collected through online questionnaires. Medical records were retrieved from the Chinese Rheumatology Information System (CRIS). Propensity scores for sample using the Generalized Boosted Model (GBM) method were used to calculate IPW, so that we produced the weighted population similar to the target of RA patients on CREDIT. Bootstrap methods were used to estimate average costs and 95% confidence intervals with 1,000 samples. Indirect costs were estimated using the human capital approach. Weighted multivariate regression identified factors influencing average annual costs.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>In this study, a total of 18,507 patients from the CREDIT database met the recruitment criteria. Among them, 1,293 patients from 152 hospitals across 29 provinces in China completed the questionnaire and were included in our analysis. The average annual total costs per patient by the Bootstrap method on the weighted population was about 41,971 CNY (Bootstrap 95%CI: 37,107\u201347,046 CNY), in which more than 75% were the direct costs. Moreover, in the direct costs, the medical costs accounted for nearly 89% and even half of them (approximately 59.7%) was medication expense. The moderate or high disease activity status, hospitalization in last year, history of comorbidity, the treatment of biologics or glucocorticoids were also found to substantially increase average annual costs of RA in our study.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This study provided reliable insight into evaluating the economic burden of RA for the individuals and their families in the real-world clinical practice of China.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0330261","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T17:24:26Z","timestamp":1756142666000},"page":"e0330261","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Average annual costs of Rheumatoid Arthritis estimated by inverse probability weighting and their influence factors: A cross-sectional study based on Chinese Registry of Rheumatoid arthritis (CREDIT) 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Rheum Dis"},{"key":"pone.0330261.ref005","volume-title":"Data of the second nationwide sample survey on disability in China: Beijing volume","author":"Beijing Office of the Second National Sample Survey on Disability in China","year":"2007"},{"issue":"10","key":"pone.0330261.ref006","doi-asserted-by":"crossref","first-page":"2750","DOI":"10.1002\/art.11439","article-title":"Direct medical costs and their predictors in patients with rheumatoid arthritis: a three-year study of 7,527 patients","volume":"48","author":"K Michaud","year":"2003","journal-title":"Arthritis Rheum"},{"issue":"6","key":"pone.0330261.ref007","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1136\/annrheumdis-2019-216243","article-title":"Economic burden of rheumatoid arthritis: a systematic review of literature in biologic era","volume":"79","author":"P-H Hsieh","year":"2020","journal-title":"Ann Rheum 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Osiri","year":"2007","journal-title":"J Rheumatol"},{"key":"pone.0330261.ref011","doi-asserted-by":"crossref","first-page":"1221393","DOI":"10.3389\/fmed.2023.1221393","article-title":"Estimation of life expectancy and healthcare cost in rheumatoid arthritis patients with and without depression: a population-based retrospective cohort study","volume":"10","author":"Y-M Chiu","year":"2023","journal-title":"Front Med (Lausanne)"},{"issue":"4","key":"pone.0330261.ref012","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1002\/acr.22160","article-title":"Societal costs of rheumatoid arthritis in China: a hospital-based cross-sectional study","volume":"66","author":"C Xu","year":"2014","journal-title":"Arthritis Care Res (Hoboken)"},{"issue":"8","key":"pone.0330261.ref013","doi-asserted-by":"crossref","first-page":"1572","DOI":"10.1111\/1756-185X.13028","article-title":"Burden of rheumatoid arthritis from a societal perspective: A prevalence-based study on cost of this illness for 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The Ministry of Human Resources and Social Security issued the national catalogue of drugs for basic medical insurance, work-related injury insurance and maternity insurance (2017 edition). https:\/\/www.gov.cn\/xinwen\/2017-02\/23\/content_5170392.htm?gs_ws=tsina_636235240978505265. 2017"},{"issue":"5","key":"pone.0330261.ref015","first-page":"836","article-title":"Chinese registry of rheumatoid arthritis (CREDIT): I. Introduction and prevalence of remission in Chinese patients with rheumatoid arthritis","volume":"36","author":"C Yu","year":"2018","journal-title":"Clin Exp Rheumatol"},{"issue":"1","key":"pone.0330261.ref016","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1093\/ckj\/sfab158","article-title":"An introduction to inverse probability of treatment weighting in observational research","volume":"15","author":"NC Chesnaye","year":"2021","journal-title":"Clin Kidney J"},{"issue":"8","key":"pone.0330261.ref017","doi-asserted-by":"crossref","first-page":"573","DOI":"10.7326\/0003-4819-147-8-200710160-00010","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"147","author":"E von Elm","year":"2007","journal-title":"Ann Intern Med"},{"issue":"9","key":"pone.0330261.ref018","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1002\/art.27584","article-title":"2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"62","author":"D Aletaha","year":"2010","journal-title":"Arthritis Rheum"},{"key":"pone.0330261.ref019","volume-title":"China statistical yearbook 2022","author":"National Bureau of Statistics of China","year":"2022"},{"issue":"1","key":"pone.0330261.ref020","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1136\/ard-2022-223413","article-title":"American College of Rheumatology\/EULAR remission criteria for rheumatoid arthritis: 2022 revision","volume":"82","author":"P Studenic","year":"2023","journal-title":"Ann Rheum Dis"},{"issue":"6","key":"pone.0330261.ref021","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1007\/s40258-018-0416-4","article-title":"Friction Cost Estimates of Productivity Costs in Cost-of-Illness Studies in Comparison with Human Capital Estimates: A Review","volume":"16","author":"J Pike","year":"2018","journal-title":"Appl Health Econ Health Policy"},{"key":"pone.0330261.ref022","volume-title":"The use of the bootstrap statistical method for the pharmacoeconomic cost analysis of skewed data","author":"A Desgagne\u0301","year":"1998"},{"issue":"397","key":"pone.0330261.ref023","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1080\/01621459.1987.10478410","article-title":"Better Bootstrap Confidence Intervals","volume":"82","author":"B Efron","year":"1987","journal-title":"Journal of the American Statistical Association"},{"key":"pone.0330261.ref024","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9780511802843","volume-title":"Bootstrap Methods and Their Application","author":"AC Davison","year":"1997"},{"issue":"3","key":"pone.0330261.ref025","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1037\/a0019623","article-title":"Propensity score techniques and the assessment of measured covariate balance to test causal associations in psychological research","volume":"15","author":"VS Harder","year":"2010","journal-title":"Psychol Methods"},{"issue":"1","key":"pone.0330261.ref026","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/art.39480","article-title":"2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis","volume":"68","author":"JA Singh","year":"2016","journal-title":"Arthritis Rheumatol"},{"issue":"6","key":"pone.0330261.ref027","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1136\/annrheumdis-2019-216655","article-title":"EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update","volume":"79","author":"JS Smolen","year":"2020","journal-title":"Ann Rheum Dis"},{"issue":"1","key":"pone.0330261.ref028","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1136\/ard-2022-223356","article-title":"EULAR recommendations for the management of rheumatoid arthritis with synthetic and 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