Societal cost of rheumatoid arthritis patients in the US

Abstract

Objective:

To estimate comprehensive cost of rheumatoid arthritis (RA) patients to society and individual stakeholders, including patients/employees, employers, family members/caregivers, and government.

Research design and methods:

Administrative claims databases covering privately insured and Medicare and Medicaid beneficiaries in the US were used to compute the excess payer and beneficiary-paid costs per patient with RA compared with matched controls. Similarly, per-person excess costs for caregivers and uninsured patients with RA were estimated. Costs were estimated for other burdens, including costs of work-loss to employers, adaptations to home and work environments, lost on-the-job productivity, informal and hired care/household help, and job turnover costs. Intangible costs associated with quality-of-life deterioration were estimated based on legal system jury awards, whereas costs for premature mortality were based on lifetime earnings data. Per-capita cost estimates were weighted by the relevant population to estimate societal costs. Because data were incomplete, several assumptions were required; these assumptions could lead to an over- or under-estimation of cost burdens.

Results:

Annual excess health care costs of RA patients were $8.4 billion, and costs of other RA consequences were $10.9 billion. These costs translate to a total annual cost of $19.3 billion. From a stakeholder perspective, 33% of the total cost was allocated to employers, 28% to patients, 20% to the government, and 19% to caregivers. Adding intangible costs of quality-of-life deterioration ($10.3 billion) and premature mortality ($9.6 billion), total annual societal costs of RA (direct, indirect, and intangible) increased to $39.2 billion.

Conclusions:

Societal costs of RA in the US are $19.3 billion and $39.2 billion (in 2005 dollars) without and with intangible costs, respectively. This study was one of the first to attempt to quantify the comprehensive burdens of RA. Despite several assumptions made in areas in which few data exist, the findings generate useful insights into the full burden of RA.

Key words::

• Burden of illness
• Caregiver costs
• Direct and indirect costs of illness
• Employer burden
• Health care expenditures
• Rheumatoid arthritis
• Societal cost

Transparency

Declaration of funding

This study was sponsored by Abbott Laboratories, Abbott Park, IL, USA.

Declaration of financial/other relationships

H.B., C.P., R.K., M.M. and Y.K. have disclosed they are employees of Analysis Group, Inc., Boston, MA, USA, which received funding for this study; M.C. has disclosed that she is an employee of Abbott.

Peer reviewers received honoraria from CMRO for their review work. Both reviewer have disclosed that they have no relevant financial relationships.

Acknowledgment

Editorial support was provided by Cathryn M. Carter of Arbor Communications, Inc., Ann Arbor, Michigan USA, and Michael A. Nissen, ELS, of Abbott.

Previous presentations of this study are as follows: Birnbaum H, Pike C, Kaufman R, Marynchenko M, Kidolezi Y, Cifaldi M. Societal Cost of Rheumatoid Arthritis (RA) in the United States: Methodology for Incorporating Intangible Costs. Value Health 2009;12(3):A16-A17. Oral Presentation MS4 at ISPOR 14th Annual International Meeting, 16--20 May 2009, Orlando, Florida, United States. Birnbaum H, Pike C, Kaufman R, Marynchenko M, Kidolezi Y, Cifaldi M. Societal Cost of Rheumatoid Arthritis: Direct and Indirect Costs in the United States. Ann Rheum Dis. 2009;68(Suppl 3):351 (THU0546).

Previous presentations of this study are as follows: Birnbaum H, Pike C, Kaufman R, Marynchenko M, Kidolezi Y, Cifaldi M. Societal Cost of Rheumatoid Arthritis (RA) in the United States: Methodology for Incorporating Intangible Costs. Value Health 2009;12(3):A16-A17. Oral Presentation MS4 at ISPOR 14th Annual International Meeting, 16--20 May 2009, Orlando, Florida, United States. Birnbaum H, Pike C, Kaufman R, Marynchenko M, Kidolezi Y, Cifaldi M. Societal Cost of Rheumatoid Arthritis: Direct and Indirect Costs in the United States. Ann Rheum Dis. 2009;68(Suppl 3):351 (THU0546).