Arthritis cases on the rise, finds comparative national study, underscoring the need for cost-effective care and disability-reduction efforts

"Arthritis and other rheumatic conditions exact a large and growing economic toll on the nation as a result of the increase in numbers of persons affected, rather than an increase in mean expenditures and earnings losses," attests Charles G. Helmick, M.D., at the National Center for Chronic Disease Prevention and Health Promotion of the Centers for Disease Control and Prevention. He bases his conclusion on a nationwide assessment of medical expenditures and earnings losses associated with arthritis in 2003, compared with figures six years before. The findings and their implications are featured in the May issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis).

The report was motivated by growing concerns about the individual and collective economic burden of arthritis, fueled by rising medical costs, from joint replacement surgery to biologic agents, and the ranks of aging Baby Boomers. A team of researchers derived estimates for 2003 from the Medical Expenditures Panel Survey (MEPS), a national probability sample of households. They tabulated medical care expenditures of adult respondents, stratified by arthritis status, and used regression techniques to assess the increment of medical care expenditures attributable to arthritis and related rheumatic diseases. They also calculated the earnings losses of working-age adults with these disabling conditions. Then, they compared estimates for 2003 with those from 1997, inflated to 2003 terms.

Among compelling findings about the state of arthritis in the United States:

• Between 1997 and 2003, the prevalence of arthritis and other rheumatic conditions increased from 36.8 million adults (18.7 percent of the population) to 46.1 million adults (21.5 percent of the population).
• Between 1997 and 2003, expenditures for arthritis medications almost doubled. The increase in spending for prescription drugs was a result of both the mean number of prescriptions, from 18.7 to 25.2 per person, and the mean cost per prescription, from $48 to $65. During this period, inpatient expenditures declined from $508 to $352 per person. As a result, the average total spent on medical care for an individual with arthritis remained surprisingly stable: $1,762 in 1997 and $1,752 in 2003.
• In 2003, Americans spent a total of $80.8 billion on medical care for arthritis, compared with $64.8 billion in 1997. Researchers attributed this rise wholly to the increase in the number of persons 18 years and older with arthritis.
• In 2003, employed adults with arthritis earned an average of $3,613 less than healthy working adults between the ages of 18 and 64. Nationwide, raw earnings losses due to arthritis totalled $108 billion, up from $99 billion in 1997.

Since the number arthritis sufferers is projected to increase steadily to nearly 67 million by 2030, as Dr. Helmick notes, the economic toll threatens to continue to escalate. He calls urgent attention to the need for cost-effective efforts to decrease medical expenses and increase the earning power of people with arthritis. To counteract disability and unemployment, possible interventions include self-management education and community-based programs to promote physical activity. "Population aging need not necessarily result in a proportionate increase in the economic impact of arthritis and other rheumatic conditions," Dr. Helmick assures.

Article: "Medical Care Expenditures and Earnings Losses Among Persons With Arthritis and Other Rheumatic Conditions in 2003, and Comparisons With 1997," Edward Yelin, Louise Murphy, Miriam G. Cisternas, Aimee J. Foreman, David J. Pasta, and Charles G. Helmick, Arthritis & Rheumatism, May 2007; (DOI: 10.1002/art.22565).