Evidence: Medical Expenditure Associated with RA

2012 Economic Review  

U.S. healthcare costs are astronomically high and one of the top healthcare expenditures globally. The Affordable Care Act, widely known as 'Obamacare', was enacted to 'curb spending' by defining and paying for quality care driven by outcomes rather than quantity of care.

In this era of understanding costs, many papers were developed to understand major cost drivers for our care system. Kawatkar et al. took a look at direct medical expenditures associated with Rheumatoid Arthritis in the U.S. population, largely from a payer perspective.

Methods: Compared RA cohort (5.8M) to control without RA (190M) using probability-weighted sample of adult respondents from the Medical Expenditure Panel Suvery (2008). Estimated annual expenditures related to pharmacy, office-based visits, emergency department visits, hospital inpatient stays, and residual. These cohorts were adjusted for sociodemographic, employment, insurance coverage, health behavior, and health status.

Results: Adjusted average annual total expenditures of RA cohort was ~$13,000 compared to control of ~$5,000. RA cohort has a significantly higher pharmacy expenditure. Summated total incremental expenditure of all RA patients in US was $22.3B ('08, USD).

Conclusion: RA patients exert considerable economic cost on US health care system primarily driven by incremental pharmacy expenditure.

Sentiment

To put this study into perspective, the total direct medical expenditure of RA was $73.4B, 0.5% of our GDP, and approximately 6.5% of our $1.14T health care spend. Incrementally, expenditure is at $22.3B on our healthcare system, about 0.16% of our GDP in 2008.

RA is a huge financial burden on our healthcare system, largely driven by expensive pharmaceutical products that aren't delivering remission and questionable improved quality of life.

As a person with RA, are your needs being met with current therapies? Are we spending almost 0.2% of our GDP on drugs that aren't meeting our expectations, increasing quality of life, or improving our overall health?