Rheumatoid arthritis costly for employers
The medical costs of employees with rheumatoid arthritis are among the highest of any chronic health condition, new research suggests.
In a study of nine large U.S. employers, researchers found that workers with rheumatoid arthritis (RA) had an average yearly medical cost of $7,337, versus $3,250 for employees without the disease.
Considering direct medical expenditures and indirect costs—like disability payment and lost work days—RA was second only to kidney failure in expense. Nearly all of the excess costs of RA were for direct medical care.
Still, lost productivity was not “unimportant,” lead study author Dr. Ronald J. Ozminkowski told Reuters Health. The typical RA patient, he said, lost about 12 days of work per year for sick days, and three to four more due to short-term disability.
To help cut these costs, the study authors conclude, employers should try to recognize which on-the-job factors contribute to disability among workers with RA.
Ozminkowski, a researcher at Thomson Medstat in Ann Arbor, Michigan, and his colleagues report the findings in the Journal of Occupational and Environmental Medicine.
Rheumatoid arthritis is an autoimmune disorder in which the immune system mistakenly attacks the lining of the joints, causing repeated episodes of inflammation, stiffness and pain. Over time, the affected joints may lose their normal shape and alignment, leading to disability.
Treatment includes a number of costly options: medications known as disease-modifying antirheumatic drugs, like methotrexate, which aim to slow the course of RA; and newer drugs called TNF-inhibitors that alter the abnormal immune response seen in the disease, and are given in injections or through an IV.
In addition, some people with RA eventually need surgery, such as joint reconstruction or replacement.
According to Ozminkowski and his colleagues, the high cost of RA is “potentially manageable” for employers as well as workers, who foot at least part of the medical bill.
For one, they recommend, employers should carefully consider RA-related benefits when choosing a health plan.
Health plans should allow “quick access” to specialists so that RA can be diagnosed early and treated properly, Ozminkowski said. Access to more-advanced drugs, rather than simple painkillers, he added, should happen “up front,” rather than only later in the course of the disease.
“RA needs to be diagnosed quickly,” he noted, “so that early treatment with disease-modifying drugs can be used to slow the progress of the condition.”
Changes in the work environment might also help minimize absenteeism and disability costs, according to Ozminkowski and his colleagues.
One study found that employees with RA whose work areas were modified in some simple way—such as a change in the computer keyboard position or a footstool added to the desk area—were 2.6 times less likely to have a work disability than employees without such modifications.
SOURCE: Journal of Occupational and Environmental Medicine, February 2006.
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