Social and economic impact of RA

Reviewed by: HU Medical Review Board | Last reviewed: September 2013. | Last updated: August 2013

RA is associated with a heavy burden on society in terms of disability and health and economic costs. Because RA tends to be progressive in nature, involving a worsening of symptoms over time, and often begins for many people during the early or middle years of life, the disease often has a long-term impact on functioning (over 30 years for many individuals), which translates to a considerable social and economic cost.1

For many patients, the chronic fatigue and pain associated with RA interferes significantly with the ability to function normally. Consequently, RA may take away a person’s ability to work. One study estimated that as many as one-third of people with RA are forced to stop working within 10 years of being diagnosed. This makes loss of productivity an important part of the overall burden of the disease. Additionally, the many health complications associated with RA make the disease expensive from a cost standpoint and can have a pronounced negative impact on quality of life.1

Fortunately, improvements in diagnosis and treatment of RA have meant that the impact of the disease on functioning and quality of life can be lessened. It is important to keep in mind that many of the studies that measure the impact of RA were conducted before some of the important recent treatment advances and don’t reflect the potential for the latest treatments to improve functioning. Many RA patients, who only decades ago would have lost the ability to work and care for themselves, with newer treatments are able to continue to work and lead full lives.


Overall impact of arthritis and rheumatism

Arthritis as a whole, including osteoarthritis, RA and other related conditions, accounts for a large share of disability among adults in the US. A 2005 CDC study found that among 47.5 million adults in the US who reported a disability, arthritis or rheumatism was the most common cause of disability, ahead of back or spine problems and heart trouble. Difficulties most commonly reported included climbing a flight of stairs and walking 3 city blocks.2


Health burden of RA

Healthcare costs associated with RA are quite high. Based on American College of Rheumatology estimates, there are a quarter of a million hospital admissions and 9 million doctor visits annually in the US due to RA.4 The annual cost of care for a patient with RA in the US averages almost $6,000 in direct costs related to RA (not including pharmaceutical costs) and another $2500 in costs not related to RA. One half of all health costs for RA are related to hospital admissions.5

The higher the disability associated with RA, the higher the health cost. For example, in one study that rated disability using the Health Assessment Questionnaire, patients who had a score of 3 on the questionnaire (this indicates a high level of disability) also had about 3 times the cost in terms of health services compared with patients who had a score of 1, which indicates a lower level of disability.6

This statistic emphasizes the importance of aggressive treatment to prevent or delay the disability that can be caused by RA.


Economic burden of RA

RA can severely restrict a person’s ability to carry out tasks related to work and may even force an individual to reduce the amount they work or make changes in employment to accommodate their disability. In some cases, where the disease is severe, a person may be forced to leave the workforce altogether. All of these scenarios translate to lost income over the course of a lifetime.4

One study found that restrictions in work often affect individuals with RA early in the course of the disease, with the use of disability benefits increasing sharply within 2 years of diagnosis.7

Another study that looked at the economic burden imposed by RA and osteoarthritis found that patients with RA had significantly higher expenses in terms of home care, child care, use of medical equipment and devices, and home remodeling than people without the disease. Patients with RA also had a significantly higher economic burden than patients with osteoarthritis and were 3 times more likely to have had a reduction in household income. Compared with osteoarthritis patients, individuals with RA had a greater reduction in work hours and a greater likelihood of having lost a job or taken early retirement. Additionally, a significantly higher percentage of RA patients in the study were unable to find work because of their condition compared with both osteoarthritis patients and people without either disease.8

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