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"Disease focus" - Rheumatoid arthritis: who bears the burden?

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    RA is one of a group of conditions classified as autoimmune diseases, where the body mistakenly attacks its own immune system. It causes inflammation of the joints, affecting fingers, wrists, feet, ankles, shoulders and knees.
     
    People with RA suffer joint pain, reduced mobility and long-term deformity and disability, as well as fatigue and depression in some cases. And, because the disease can affect the body as a whole, it can damage internal organs and the vascular system.

    It is estimated that the worldwide prevalence of RA is between 0.5% and 1% of the population1,2. According to US research, this means that every year you can expect to see around 41 new cases diagnosed per 100,000 people3. The prevalence of RA is typically higher in women than men1.

    Counting the costs
    RA can strike at any age and is often diagnosed in middle age (between 30 and 60 years). This can be a crucial time of life for those affected. People in their 30s and 40s are often at a key stage of their career and family lives. Unfortunately, moderate to severe RA can have a significant detrimental impact on both1.

    People with RA face a higher likelihood of becoming unemployed and reducing working hours. The rate of premature retirement is estimated at between 30% and 40% after ten years of RA4. Twenty-five years after being diagnosed with RA, approximately 50% of patients are no longer employed4.

    Reduced productivity is bad news for everyone. Those directly affected see their family’s income fall, while employers can miss out on the contribution of valuable employees who may also be entitled to sick pay. For governments and private insurers, disability benefits payments may also apply.

    The cost of hospitalisation, laboratory tests, medications and health professional consultations also stack up. The absolute figures can vary widely from one country to the next – specialist hospital care in the United States is typically more expensive than in Brazil.

    A French study put the societal cost of RA at close to €22,000 per patient per year, while the cost to the state was just under €12,0005.
     
    Of course, if you really want to know the real costs, ask the patients. For them, the greatest loss is often the freedom to fulfil their social function which could include doing their job, and taking care of children or grandchildren.

    The joint pain and reduced mobility affect daily activities and productivity in the workplace, as well as psychological and emotional well-being, fatigue and sleep quality, matter a great deal to many patients.

    Solutions from science
    Due to greater life expectancy, there are more people with RA today than ever before. Rising prevalence of RA and other chronic autoimmune disorders has the potential to send costs spiralling out of control.

    So what is the solution? The permanent damage wreaked by RA can force people in the prime of their lives to swap the workplace for a diary full of medical appointments.

    The key to shifting the balance away from healthcare resource consumption and back towards preserved productivity is to prevent irreversible damage to joints.

    ‘Prevention is better than cure’ – we say it all the time, and while it may not be possible to prevent RA entirely, it may be feasible to limit its progression.

    In recent years approaches to treating RA have changed how patients are cared for and transformed their prognosis. By treating patients until their symptoms are under control – an approach known as treat-to-target6 –  joint damage could be prevented or minimised7.

    Early diagnosis coupled with swift deployment of innovative treatments for RA can keep people in the workplace and out of hospital. Balanced against the price of medicines are the health services costs, but mainly the value that people in the prime of their lives can offer society.

    They can continue being productive; they can continue being parents, spouses and community volunteers. They can continue being themselves.

    References

    1. Boonen A, Severens JL;  The burden of illness of rheumatoid arthritis. Clin Rheumatol 2011;30 (Suppl 1):S3-S8

    2. Gabriel SE, Michaud K. Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Research & Therapy 2009;11:229

    3. Myasoedova E, Crowson CS, Maradit H, Therneau TM, Gabriel SE. Is the Incidence of Rheumatoid Arthritis Rising? Arthritis & Rheumatism 2010; 62:1576-1582

    4. Allaire S, Wolfe F, Niu J, Lavalley MP.  Contemporary prevalence and incidence of work disability associated with rheumatoid arthritis in the US. Arthritis & Rheumatism 2008;59: 474–480

    5. PRMA Insights: Pricing and Reimbursement Success in Rheumatoid Arthritis. November 2011.P172

    6. Smolen JS et al. Treating rheumatoid arthritis to target: recommendations of an international task force. Ann Rheum Dis 2010;69:631-637

    7. Smolen JS. Treat-to-Target: rationale and strategies. Clin Exp Rheumatol 2012;30 (Suppl. 73): S2-S6.


    IMNL-OTH-025702-012014


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