The economic burden associated with osteoarthritis, rheumatoid arthritis, and hypertension: a comparative study

• Published in: Annals of the rheumatic diseases Vol. 63; no. 4; pp. 395 - 401
• Main Authors: Maetzel, A, Li, L C, Pencharz, J, Tomlinson, G, Bombardier, C
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.04.2004; BMJ; BMJ Publishing Group Ltd; Elsevier Limited
• Subjects: Aged; Arterial hypertension. Arterial hypotension; Arthritis, Rheumatoid - diagnosis; Arthritis, Rheumatoid - economics; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Caregivers - economics; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; COI; Cost estimates; Cost of Illness; costs; Disease; Diseases of the osteoarticular system; Economic aspects; Employment - economics; Evaluation; Extended Report; Female; GDP; generalised linear modelling; GLM; Gross Domestic Product; HBP; Health Care Costs; Health care expenditures; high blood pressure; Humans; Hypertension; Hypertension - diagnosis; Hypertension - economics; Inflammatory joint diseases; Male; Medical care, Cost of; Medical personnel; Medical sciences; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; OLS; ordinary least squares; Osteoarthritis; Osteoarthritis - diagnosis; Osteoarthritis - economics; Osteoarthritis, Hip - economics; Osteoarthritis, Knee - economics; Patient Acceptance of Health Care; Patients; Physicians; Professionals; Purchasing power parity; Quality of life; Questionnaires; Rheumatoid arthritis; Surveys and Questionnaires; Transportation services; Canada; Hypertension; Immunopathology; Diseases of the osteoarticular system; Rheumatology; Cardiovascular disease; Autoimmune disease; Inflammatory joint disease; Chronic; Rheumatoid arthritis; Arthropathy; Degenerative disease; Osteoarthritis; Comparative study
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.2003.006031

Objective: To compare the economic burden to society incurred by patients with RA, OA, or high blood pressure (HBP) in Ontario, Canada. Methods: Consecutive subjects recruited by 52 rheumatologists (RA) and 76 family physicians (OA and HBP) were interviewed at baseline and 3 months. Information was collected on demographics, health status, and any comorbidities. A detailed, open ended resource utilisation questionnaire inquired about the use of medical and non-medical resources and patient and care giver losses of time and related expenses. Annual costs were derived as recommended by national costing guidelines and converted to American dollars (year 2000). Statistical comparisons were made using ordinary least squares regression on raw and log transformed costs, and generalised linear modelling with adjustment for age, sex, educational attainment, and presence of comorbidities. Results: Baseline and 3 month interviews were completed by 253/292 (86.6%) patients with RA and 473/585 (80.9%) patients with OA and/or HBP. Baseline and total annual disease costs for RA (n = 253), OA and HBP (n = 191), OA (n = 140), and HBP (n = 142), respectively, were $9300, $4900, $5700, and US$3900. Indirect costs related to RA were up to five times higher than indirect costs incurred by patients with OA or HBP, or both. The presence of comorbidities was associated with disease costs for all diagnoses, cancelling out potential effects of age or sex. Conclusion: The economic burden incurred by RA significantly exceeds that related to OA and HBP, while differences between patients with a diagnosis of OA without HBP or a diagnosis of HBP alone were non-significant, largely owing to the influence of comorbidities.