Arthritis and other rheumatic conditions cost the U.S. $128 billion in 2003, researchers report

Costs due to arthritis and rheumatic conditions are expected to increase due to an aging population, increased obesity and inactivity.

Costs directly attributable to arthritis and other rheumatic conditions in the United States increased 24% between 1997 and 2003 to total $80.8 billion, according to study by researchers with the Centers for Disease Control and Prevention.

"The substantially increased costs of AORC (arthritis and other rheumatic conditions) in 2003 were driven by an increase in number of persons with AORC. Costs likely will continue rising because the number of persons with arthritis is projected to continue to increase, with another eight million arthritis cases anticipated during 2005 to 2015.

"Without cost-reduction strategies, the economic burden of AORC will continue to increase. This trend underscores the need for wide-scale implementation of interventions that reduce medical expenditures and lost earnings among persons with AORC," the study authors reported.

Edward Yelin, PhD, an adjunct professor of rheumatology at the University of San Francisco, and colleagues at several centers in the U.S., analyzed data from the household component of the Medical Expenditure Panel Survey (MEPS) to estimate both national and state-specific direct and indirect costs attributable to AORC during 2003.

The MEPS is an annual household interview survey designed to represent the overall U.S. civilian, noninstitutionalized population.

In 2003, both direct and indirect costs from AORC totaled approximately $128 billion, equal to 1.2% of the 2003 U.S. gross domestic product. This figure includes about $80.8 billion in direct costs, such as actual medical expenditures, and about $47 billion in indirect costs, such as lost wages, according to the report, published in the January 12 edition of Morbidity and Mortality Weekly Report.

The authors noted that direct costs attributable to AORC increased 24% from $64.8 billion in 1997. However, per-person direct costs remained similar, averaging $1,762 in 1997 and $1,752 in 2003, despite the introduction of new drugs, such as COX-2 inhibitors like Celebrex (celecoxib, Pfizer) and increased numbers of hip and knee replacements.

"The increase in total direct costs resulted from the increase in the number of persons with AORC in 2003, attributable to the increase in population and the increased prevalence of self-reported AORC among adults aged [older than] 50 years," the authors wrote.

Total costs from arthritis and other rheumatic conditions varied by state and ranged from $225.5 million in Washington, D.C., to $12.1 billion in California. New York and Texas had the next highest total costs at $8.7 billion, according to the report.

"Total costs attributable to AORC have increased substantially since 1997, and that increase is expected to continue because of the aging of the population and increases in obesity and physical inactivity," the study authors wrote.

"These findings signal the need for broader implementation of effective public health interventions, such as arthritis and chronic disease self-management programs, which can reduce medical expenditures among persons with AORC," they noted.

Overall, the 2003 MEPS sample included 23,352 people aged 18 years and older and had a 71.9% response rate. Among respondents, 4,801 people met the case definition for AORC. Based on the sample population, roughly 46.1 million people aged 18 years and older reported having AORC in 2003, for an average per-person direct cost of $1,752.

Ambulatory care accounted for the highest per-person direct costs, averaging $914, followed by emergency department and inpatient services at $352, prescriptions at $338 and other costs at $146.

Indirect costs totaled $47 billion among 29.5 million working-age adults, with per-person lost earnings averaging $1,590, according to the report.

For more information:
Yelin E, Cisternas M, et al. National and state medical expenditures and lost earnings attributable to arthritis and other rheumatic conditions — United States, 2003. MMWR Morb Mortal Wkly Rep. 2007;56:4-7.