Autoimmune Diseases Cost US More Than $100 Billion Annually

A report recently released by the American Autoimmune Related Diseases Association (AARDA), notes that more than 50 million Americans are affected by an autoimmune disease such as rheumatoid arthritis, psoriasis, and lupus. The report discusses the rising incidence of autoimmune diseases, outlines the increasing costs associated with these conditions, and offers policy recommendations designed to improve care.

The AARDA report “The Cost Burden of Autoimmune Disease: The Latest Front in the War on Healthcare Spending,” says that “autoimmune diseases have been reported to be on the rise in the U.S. and around the world, making this poorly understood category of disease a public health crisis at levels comparable to heart disease and cancer.” Citing a “severe lack of awareness” among the general public and medical community, “unequal allocation of research funding and focus,” and “a lack of coordinated care and standardized diagnostic tests,” the report claims that “the associated cost of autoimmune diseases has become a significant portion of the rising cost of healthcare in the US.”

Although the AARDA estimates that 50 million Americans have an autoimmune disease, the report notes that there is insufficient epidemiological data available to determine “the full direct and indirect cost to the overall health care system due to autoimmune disease.” The National Institutes of Allergy and Infectious Diseases (NIAID) has estimated that the cost of treating autoimmune disease in the US is greater than $100 billion annually, a figure that the AARDA report says “is likely a vast understatement of the true costs of autoimmune disease as the annual costs of only seven of the 100+ known autoimmune diseases -- Crohn’s disease, ulcerative colitis, systemic lupus erythematosus (SLE), multiple sclerosis (MS), rheumatoid arthritis (RA), psoriasis, and scleroderma -- are estimated through epidemiological studies to total from $51.8-$70.6 billion annually.”

The report estimates that the annual direct cost of treating rheumatoid arthritis in the US is $10.9 billion, with indirect costs totaling $8.4 billion. It cites a survey published in the Journal of Rheumatology that found that “not only are estimated average earnings decreased in RA patients from $18,409 to $13,900 per year, but additionally the number of jobs patients could perform [has] dropped from 11.5 million to 2.6 million.” Thus, 50% of patients with RA become unable to work within ten years of disease onset.

Citing the publication “The Burden of Musculoskeletal Diseases,” the AARDA report says that RA patients “accounted for 1.1 million ambulatory care visits in 2004, representing 2.4% of the 44.2 million non-injury emergency room visits with a primary diagnosis of Arthritis and Other Rheumatic Conditions (AORC).” RA patients also accounted for 2% (18,000) of the 922,100 non-federal, short stay hospitalizations for AORC in 2004.

The direct and indirect costs of RA and other autoimmune diseases mean that “the importance of an early diagnosis and onset of treatment is key in minimizing life altering complications that can occur as a result of autoimmune disease… Therefore, obtaining the recommended care for autoimmune disease patients is paramount.”

The report also states that “the addition of new cutting edge biologic treatments for autoimmune patients requires an even higher level of coordination and expertise from physicians as these treatments, while revolutionary as lifesaving and quality of life-enhancing tools, must be heavily monitored for short-term and long-term adverse side effects and dosage issues.”

In a news release accompanying the release of the report, AARDA Executive Director Virginia Ladd offered several recommendation for reducing the costs associated with rheumatoid arthritis and other autoimmune diseases and improving the care delivered to patients:

• Streamline the diagnosis process which right now can take years and numerous doctor visits.
• Create a new medical specialist — the autoimmunologist.
• Coordinate and manage patient care through community-based autoimmune triage centers rather than costly hospital emergency room visits and extended hospital stays.
• Focus and expand federal research funding for autoimmune disease that leads to better diagnostic tools and new treatment options.
• Increase awareness amongt the general public about autoimmunity and autoimmune disease so they can be better advocates for their own health and their loved ones.

HCPLive wants to know:

Do you agree with the AARDA that creating the new medical specialty of “autoimmunologist” is essential to improving the care of patients with rheumatoid arthritis and other autoimmune diseases?

Is there a lack of awareness of the true disease burden of RA and other autoimmune diseases among medical professionals? If so, to what do you attribute this deficiency?

How harmful is prolonged time-to-diagnosis/delayed diagnosis? Does something other than the complexity of diagnosing diseases with overlapping symptoms account for this phenomenon?

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