Double Costs, Fewer Doctor Visits in Rheumatology

Rheumatic disease patients are paying double for out-of-pocket healthcare costs this year as compared to 2019, according to the results of patient survey issued by the American College of Rheumatology (ACR).

In 2019, patients reported paying $475 in out-of-pocket costs, but in 2020, patients reported paying an annual average of $1,000 in out-of-pocket costs for healthcare to date.

The survey was conducted by ACR and the results were released this month as part of Rheumatic Disease Awareness Month, which is hosted by the ACR and its Simple Tasks awareness campaign.

COVID-19 has proven to be challenging for this patient population. In addition to increasing out-of-pocket costs, they report never before seen challenges in lifestyle and healthcare factors.

Fewer patients are saw a rheumatologist between 2019-2020. Specifically, 52 percent fewer patients saw a rheumatologist. And, most are utilizing telemedicine with 66 percent having at least one telemedicine visit within the last year.

In 2020, one-third (33.53 percent) of patients said they were currently being treated, while about 38.23 percent said they used to be treated by a rheumatologist or rheumatology provider. In 2019, about 57.41% said they were currently being treated by a rheumatologist.

There was also an increase in wait times to see a rheumatologist with 17.13 percent of patients in 2020 waiting 61-90 days for first appointment compared to only 13.39 percent in 2019.

“These results could be attributed to factors such as the COVID-19 pandemic, an incre thenumber of individuals without health insurance, and the growing nationwide shortage of rheumatology health professionals,” the authors of the survey wrote.

Step therapy continues to be a concern with 46.17 percent of patients reporting that their insurer required patients to accept therapies preferred by the insurer before the doctor-recommended drug therapy would be authorized for payment. And, 47.94 percent of patients said that their provider needed to obtain prior authorization for a prescription.

Nearly half of patients at 49.20% percent said they had difficulty fillinga prescription because the medication was not in stock, specifically:hydroxychloroquine (Plaquenil, Quineprox); methotrexate (Otrexup, Rasuvo, Rheumatrex, Trexall, Xatmep); gabapentin (Gralise, Horizant, Neurontin, Gabarone); acetaminophen (Tylenol, Actamin, and others); and, ibuprofen (Advil, Motrin, and others).

About 35% of patients reported they were prescribed a biosimilar, however, only 28.91 percent were not sure whether they had been prescribed a biosimilar drug, “suggesting a possible lack of patient education about biosimilars and how they compare to bio-originators.”

The vast majority— approximately 83%—reported at least one activity limitation as a result of their disease, including the ability to exercise, work, and perform physical activities. And, 68 percent of patients reported their disease sometimes feels invisible because they don’t “look sick” to most people.

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REFERENCE

2020 Rheumatic Disease Patient Survey​

For more information about Rheumatic Disease Awareness Month, visit ACR’s “My Disease May be Invisible, But I’m Not” awareness campaign website.