ATLANTA, Georgia—According to the US Centers for Disease Control (CDC), arthritis and other rheumatic conditions (AORC) cost the US $128 billion in 2003, a 24% surge since 1997 and an amount equal to 1.2% of the gross domestic product (GDP).¹

The surprise in this report, which summarizes research led by Edward H. Yelin, PhD, is that direct medical costs per patient actually decreased slightly despite the introduction of expensive new treatments (ie, biologicals and coxibs) and the increased use of knee and hip replacements. The full report will appear in Arthritis & Rheumatism.²

Dr. Yelin told CIAOMed that this largely reflects the fact that osteoarthritis (OA) and related conditions account for the bulk of AORC. "The cost of their treatment did not change much, resulting in virtually no change on average. Rheumatoid arthritis is only a very small part of total arthritis costs, but it is a big part of rheumatologists' practices," he said. "The main message is that we're seeing the beginnings of the effect of population aging, with greater total costs due to the growing numbers with AORC, even though the per-case cost is not changing that much."

Report calls for more arthritis self-management programs

Costs for AORC were estimated from the household component of the 2003 Medical Expenditure Panel Survey (MEPS), an annual household interview of medical conditions, medical system expenditures, and earnings and employment history. The data do not include nursing home residents and do not include persons under age 18.

The average per-person cost for direct medical care in 2003 was $1752. This includes costs for ambulatory care, emergency department and inpatient services, prescriptions, and other costs such as home healthcare and medical devices. It does not include nursing home care.

Total direct costs increased 24% during 1997-2003, from $64.8 billion (in 2003 dollars) to $80.8 billion. "The increase in total direct costs resulted from the increase in the number of persons (9 million) with AORC in 2003, attributable to the increase in population (predominantly in the 45-64 years cohort) and the increased prevalence of self-reported AORC among adults aged >e;50 years," Dr. Yelin writes. This is likely an underestimation because it does not include costs to nursing home residents or those associated with complementary and alternative medicine, nondurable medical goods, or long-term mental healthcare.

The 2003 total for indirect costs such as lost earnings was $47 billion. 

"Total costs attributable to AORC have increased substantially since 1997, and that increase is expected to continue because of the aging of the population and increases in obesity and physical activity," writes Dr. Yelin, who is professor of medicine and health policy, division of rheumatology, University of California, at San Francisco. "These findings signal the need for broader implementation of effective public health interventions, such as arthritis and chronic disease self-management programs, which can reduce medical expenditures among persons with AORC."

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Reference

1. Centers for Disease Control. National and state medical expenditures and lost earnings attributable to arthritis and other rheumatic conditions—United States, 2003. Morb Mortal Wkly Rep. 2007;56:4-7.
2. Yelin E, Murphy L, Cisternas M, et al. Medical care expenditures and earnings losses of persons with arthritis and other rheumatic conditions in 2003 with comparisons to 1997. Arthritis Rheum. 2007. In Press. Available at: www.cdc.gov/mmwr/preview/mmwrhtml/mm5601a2.htm?s_cid=mm5601a2_e.
Accessed January 30, 2007.