In most cases, rheumatoid arthritis (RA) requires consistent aggressive treatment for many years to control symptoms, manage pain, and stop disease progression. There are a number of different treatment options, which can all be combined to create a well-rounded treatment strategy.
Treatment for RA includes a variety of medications, therapy and possibly even surgery. All these treatment types have their own associated costs, which begin to add up for patients suffering from this chronic disease.
It is estimated that the direct health care costs, as well as the consequential costs of RA in the United States, are over $19 billion annually.
A RA patient at any given time is likely undergoing several different forms of treatment. These treatment forms may include:
Many of these treatments require monthly or regular spending in order to maintain health. Depending on the health insurance plan (if there even is one), patients may wind up paying large portions of these RA treatment costs out of pocket.
RA medications can be extremely costly. Many patients can pay up to $30,000 annually for their medication costs alone. Over the course of a lifetime, this figure quickly becomes astronomical, especially for patients diagnosed early on in their lives.
While health insurance may cover a portion of this, it becomes difficult to pay for these medications out of pocket. In some cases, patients who are covered by medical insurance can still end up paying 30% or more of the total costs of certain medications.
A recent research report from GBI Research estimated that the value of the United States RA medication market will increase from $6.4 billion in 2013 to $9.3 billion by 2020. The reason for this drastic increase is because there are many newer medications available today that cost more than their predecessors.
NSAIDs and analgesics are prolific in our society, and so their availability makes them much more affordable. However, specialized RA medications are much more expensive. Conventional DMARDs have dropped in price drastically since they first came onto the market.
Many types of conventional DMARDs are much more affordable today. However, biologics, which are the newer class of immunotherapy drugs, are currently very expensive and can be a serious financial burden on many people.
Conventional DMARDs have come down in price significantly. They are much more affordable today than they were several years ago. Most patients can expect to pay between $1,500 and $2,000 annually for conventional DMARD medications. These costs will vary by the type and brand of medications.
Biologics are the newest forms of RA treatments. Massive investments in research have gone into to developing biologics and making them available to patients. For this reason, they are the most expensive forms of medications available to patients today. Adding to the expense is the fact that biologics are usually administered by a healthcare professional through an IV or by injection. This alone creates additional health care costs.
Depending on the type of biologic medication being taken, the monthly costs can range from $1,300 to $3,000 per patient. This means that in many cases, biologics alone may cost the patient well over $30,000 annually without health insurance or financial assistance of some kind.
Some patients don’t respond well to treatments or their joints begin to deteriorate rapidly. In this case, doctors may recommend specific types of surgery, such as joint replacements or arthroscopic surgeries, to restore mobility and reduce pain.
The costs for RA surgeries, especially joint replacement surgeries, can be tens of thousands of dollars. The average cost of a total knee replacement surgery in the United States is about $31,124 (according to Blue Cross Blue Shield). This number can range from as low as $11,317 in Montgomery, Alabama to as much as $69,654 in New York, New York.
The out of pocket expenses for these types of surgeries can range significantly based on the level of insurance coverage. Additional costs are usually also incurred out of pocket due to certain requirements for recovery. This may include additional physical therapy, medications, or assistive devices.
Beyond the RA treatment costs of surgeries and medications like DMARDs and biologics, patients can also wind up paying for many additional expenses such as the costs of ibuprofen and other over the counter NSAIDs which are being taken regularly. Though these are much more affordable than DMARDs or biologics, the costs will start to add up.
In severe cases, patients may require corticosteroids, which are available only by prescription. These medications can range anywhere from $25 up to $300 or more depending on the specific medication prescribed (and of course depending on the insurance coverage).
Other medical and treatment expenses may include physical and occupational therapy, which are professional services that can cost hundreds of dollars per hour. In addition, many patients require special products and assistive devices, which all incur additional costs. Orthotics, canes, walking assists, special cooking utensils, and more may all need to be purchased out of pocket by many RA patients over the course of their lives.
RA treatment costs can be a major financial burden on patients and their families as well as on healthcare as a whole. Yet, there are also additional indirect costs of the disease including not just healthcare costs but economic costs as well.
Due to the nature of the illness, many people find they become too debilitated to continue to work full-time. This creates additional economic costs due to low productivity, absenteeism, and lost wages. It is estimated that indirect costs per patient in the United States can range from $1,500 to $22,000 annually. Additionally, many patients end up leaving their jobs and requiring disability, which costs on average $10,000 per patient annually. These additional costs can continue to accumulate and become an enormous financial and economic burden.
Unfortunately, for many patients who aren’t fully or even partially covered by health insurance, the decision as to which treatments to pursue often becomes a tradeoff between the treatment’s effectiveness and the costs.
Ideally, patients can find a personalized medication and treatment plan that provides symptom relief, manages the disease and doesn’t cause unreasonable financial stress.