The Results:
(Direct Cost)
The average total direct cost of rheumatoid arthritis for all of the participants of this study was $200/month.
- Health care visits, medications, and radiographs accounted for 78% of that total direct cost.
- Only 3.5% of the total could be attributed to cost for hospitalization.
Further analysis revealed that shorter disease duration and the number of comorbid conditions were significantly linked to higher total direct cost of rheumatoid arthritis.
No significant correlation was seen between other demographic, psychosocial, or disease activity factors, and total direct cost of rheumatoid arthritis.
A significant difference in direct cost was found between the faction reporting disease duration less than six months ($240/month plus or minus 285) versus duration of more than six months ($144/month plus or minus 149). Significantly higher cost of physician visits, lab tests, and radiographs for the group with shorter disease duration was recognized as the cause of the difference.
With regard to the number of healthcare visits or monthly direct cost, a distinct difference was not found between participants enrolled in managed care health plans or traditional health insurance plans. A difference was not found between participants with copayment plans as opposed to plans not requiring a copayment either.
The average out-of-pocket cost of rheumatoid arthritis for all participants was $81.88/month (plus or minus 127.89), with a median of $33.33 and range of $0-$900, which accounted for nearly half of the mean total direct cost of rheumatoid arthritis.
(Indirect Cost)
Of the 150 study participants, 77 reported missed days of usual activities due to their arthritis. The average number of missed days was 3.8/month (plus or minus 7.7) resulting in an average indirect cost of $281/month (plus or minus 546). The number of reported missed days was higher for the group with disease duration less than 6 months when compare to the group with disease duration higher than 6 months, as was the indirect cost:
- $348/month (plus or minus 567) for less than 6 month duration
- $188/month (plus or minus 506) for greater than 6 month duration
Of the 95 participants who worked prior to disease onset, 12 reported being disabled and 5 reported being on sick leave as a consequence of rheumatoid arthritis, indicative of a work disability rate of 18%.
Disabled participants reported significantly lower household incomes and higher HAQ disability scores than the employed participants.
Twenty-one employed participants reported a change in the number of hours worked as a result of their arthritic condition for the 6-month period prior to study enrollment, either by reducing hours or changing the starting or quitting time. Four participants reported that other family members sometimes stayed home from work or worked less hours in order to assist them.
After all of the answers to the questionnaires were analyzed and the calculations made, it could be concluded from the study that the direct and indirect cost of seropositive rheumatoid arthritis during the year following disease onset is substantial.
Related Resources
Source: Direct and Indirect Costs Associated with the Onset of Seropositive Rheumatoid Arthritis, KATHERINE NEWHALL-PERRY, et al., The Journal of Rheumatology, May 2000,
First published: 05/23/2000
