Price of Gout Flare: $1,084

It may not be a surprise that having more gout flares in a year is more costly, but a recent study has quantified just how much more expensive they are.

In a retrospective cohort study of 102,703 patients with gout whose records are captured in the database of a large U.S. insurer, Robert Jackson, MD, and colleagues found that people who have 3 or more flares in the first year after diagnosis have healthcare costs that are 140 percent higher than those who have only 0-1 flares. Those with 2 flares in a year had costs that were 67 percent higher.

Based on medical and pharmaceutical claims data, the authors calculated the adjusted annual gout-related costs to be $1,804 for 0-1 flare, $3,014 for 2 flares, and $4363 for three or more flares. The study appears in the June 2015 issue of BMJ Open.

The team also identified several patient characteristics associated with more flare ups, such as being older, male, African-American, and living in the Northeast or Midwest.

Gout is the most common inflammatory arthritis in US, affecting 3.9 percent or 8.3 million people. Its painful attacks or “flares” are a major clinical burden. Studies have shown that 60 percent of patients have a recurrent gout flare within 1 year after their initial event; 78 percent have one within 2 years. In addition to the pain, these events come with a high cost: the estimated direct cost is $4 billion and the estimated annual indirect cost is $2.6 billion.

About 3.7 percent of the population of patients included in the study had three or more flares in a year. Although the proportion of patients with frequent gout flares was small in this group, these patients have a high burden in terms of health care costs and resource use.

The results of this analysis suggest there is a significant cost benefit to using prophylactic therapy to tightly control serum uric acid levels in gout patients with the goal of reducing flare frequency to fewer than two per year, the authors write.