RA Costs More Than You May Think – Patient Out of Pocket Expenses
Last updated: March 2022
Between June and August of this year, Rheumatoidarthritis.net utilized an online survey to gauge trends in RA patients. The entire survey results, containing over 1,000 patient responses, are available at https://rheumatoidarthritis.net/ra-in-america-2013/. Part of this survey focused on the financial impact of the disease on patients.
How much does RA cost?
It was found that 44% of patients spent $1,000-$5,000 out of pocket each year while 12% indicated that they spent between $5,000-$10,000 annually. Almost 44% indicated that they avoided a treatment due to costs.
These survey results were recently picked up and reported by the American College of Rheumatology’s (ACR) magazine The Rheumatologist. This means that members of the ACR, which includes thousands of rheumatology doctors in the United States, will have an opportunity to read about the financial hardships on patients and potential impact on treatment decisions. In the article, Dr. Coblyn from Harvard Medical School responded to the survey results, “It didn’t surprise me, intellectually, but I was surprised to see almost half of RA patients are spending $5,000 a year out of pocket…it’s unsettling because we have these drugs, which are terrific, and some patients will not have access to them.”
What are common out of pocket expenses for RA?
Out of curiosity, I decided to make an accounting of my own annual out of pocket costs. I tried to think about everything related to RA for which I paid. Below is my accounting.
- Parking - Parking charge for clinic, $6.00 per trip to clinic for doctor visits and infusions x 22 trips = $132
- Mileage – Driving to clinic for doctor visits and infusions, 22 trips x 30 miles round trip = 660 miles/24 miles per gallon = 27.5 gallons x $3.50 per gallon = $96.25
- Insurance Co-pays – I have a maximum out of pocket of $2,500 annually and this was fully met the past few years due to the costs of office visits to expensive specialists, imaging including MRIs, RA related surgeries, expensive medications, etc.
- Office Visit Co-pays- For my insurance, each office visit is covered except for a $15 copay that I pay at the appointment. 10 visits x $15 = $150
- Prescription Co-pays - Most of my prescriptions have a $5-$50 copay. It helps when I can get a 90 day supply but that doesn’t always work. 15 refills per year x $10 average = $150. It is helpful when a pharmaceutical company offers a co-pay assistance plan.
- Missed work – Fortunately I am salaried and can flex my schedule as needed. But the work still must get done. Many RA patients are hourly employees and missed work may mean missed pay.
- Over the counter drugs – Tylenol, Prilosec, vitamins, etc. estimated $250 per year.
- Medical Supplies/Assistive Devices - Bandages for post surgery, ice packs, crutches, canes, jar openers, etc. estimated $200
This is a grand total of $3,478.25 for the year that comes out of my own pocket. That is right in line with the survey results. And with federal changes in healthcare rules, my own out of pocket expenses will dramatically escalate over the next few years by a rate of several thousand dollars as insurance companies pass on the costs of insuring more patients onto those who are the biggest users of healthcare.
Granted, this amount does not compare to the total cost of treatment for the year that can run upwards of $40,000 depending on medications, imaging, and surgeries. But it’s still a lot of money that could be used for other things like a new car, a vacation, clothes for my kids, house repairs, savings, etc. People with chronic illnesses must find a way to live with these added expenses. Rheumatoid arthritis is costly in so many ways.
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