Skip to main content

Advertisement

Log in

The burden of illness of rheumatoid arthritis

  • Review
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

It is necessary to understand the full burden of illness of a disease before the value of interventions can be assessed. Rheumatoid arthritis (RA) has an impact on a variety of stakeholders, including patients, healthcare systems, and society as a whole. This overview discusses the societal and patient perspectives, distinguishing several domains of impact. Epidemiology is important from a societal perspective, as it affects the total impact on health and costs related to RA and influences healthcare organization priorities. Co-morbidities, such as cardiovascular disease, are important factors contributing to the impact of RA. The impact on health is, naturally, relevant to both patients and society as a whole, and is summarized by health-related quality-of-life measures from the point of view of the patient and by utilities from the societal perspective. Similarly, work participation is important for both patients and society. Withdrawal from the labor force and short- and long-term sick leave are extensively studied in RA and lead to substantial productivity costs at the societal level and to income loss for patients. In addition, the recent concept of presenteeism, which reflects the problems that patients experience while at work, is considered. Finally, the costs of illness of RA are summarized. Societal costs are mainly driven by the costs of drug treatment and inpatient care, including surgery. Patient and family costs are mainly driven by the need for formal and informal care. Overall, RA has a significant impact on the health of and costs to patients and society, suggesting that effective interventions to reduce the impact are of value.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Gabriel SE, Michaud K (2009) Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Res Ther 11:229

    Article  PubMed  Google Scholar 

  2. Chorus AM, Miedema HS, Boonen A, van der Linden S (2003) Quality of life and work in patients with rheumatoid arthritis and ankylosing spondylitis of working age. Ann Rheum Dis 62:1178–1184

    Article  PubMed  CAS  Google Scholar 

  3. World Health Organization. International Classification of Functioning, Disability and Health (ICF). Geneva: WHO. Available at: http://www.who.int/classifications/icf/en/. Accessed August 2010

  4. Torrance GW (1986) Measurement of health state utilities for economic appraisal. J Health Econ 5:1–30

    Article  PubMed  CAS  Google Scholar 

  5. Bansback N, Harrison M, Brazier J, Davies L, Kopec J, Marra C, Symmons D, Anis A (2008) Health state utility values: a description of their development and application for rheumatic diseases. Arthritis Rheum 59:1018–1026

    Article  PubMed  Google Scholar 

  6. Marra CA, Rashidi AA, Guh D, Kopec JA, Abrahamowicz M, Esdaile JM, Brazier JE, Fortin PR, Anis AH (2005) A comparison of generic, indirect utility measures (the HUI2, HUI3, SF-6D, and the EQ-5D) and disease-specific instruments (the RAQoL and the HAQ) in rheumatoid arthritis. Soc Sci Med 60:1571–1582

    Article  PubMed  Google Scholar 

  7. Geuskens GA, Burdorf A, Hazes JM (2007) Consequences of rheumatoid arthritis for performance of social roles—a literature review. J Rheumatol 34:1248–1260

    PubMed  Google Scholar 

  8. Wolfe F, Allaire S, Michaud K (2007) The prevalence and incidence of work disability in rheumatoid arthritis, and the effect of anti-tumor necrosis factor on work disability. J Rheumatol 34:2211–2217

    PubMed  CAS  Google Scholar 

  9. Verstappen SM, Bijlsma JW, Verkleij H, Buskens E, Blaauw AA, ter Borg EJ, Jacobs JW, Utrecht Rheumatoid Arthritis Cohort Study Group (2004) Overview of work disability in rheumatoid arthritis patients as observed in cross-sectional and longitudinal surveys. Arthritis Rheum 51:488–497

    Article  PubMed  CAS  Google Scholar 

  10. de Croon EM, Sluiter JK, Nijssen TF, Dijkmans BA, Lankhorst GJ, Frings-Dresen MH (2004) Predictive factors of work disability in rheumatoid arthritis: a systematic literature review. Ann Rheum Dis 63:1362–1367

    Article  PubMed  Google Scholar 

  11. Mau W, Listing J, Huscher D, Zeidler H, Zink A (2005) Employment across chronic inflammatory rheumatic diseases and comparison with the general population. J Rheumatol 32:721–728

    PubMed  Google Scholar 

  12. Chung CP, Sokka T, Arbogast PG, Pincus T (2006) Work disability in early rheumatoid arthritis: higher rates but better clinical status in Finland compared with the US. Ann Rheum Dis 65:1653–1657

    Article  PubMed  CAS  Google Scholar 

  13. de Buck PD, de Bock GH, van Dijk F, van den Hout WB, Vandenbroucke JP, Vliet Vlieland TP (2006) Sick leave as a predictor of job loss in patients with chronic arthritis. Int Arch Occup Environ Health 80:160–170

    Article  PubMed  Google Scholar 

  14. Björk M, Thyberg I, Rikner K, Balogh I, Gerdle B (2009) Sick leave before and after diagnosis of rheumatoid arthritis—a report from the Swedish TIRA Project. J Rheumatol 36:1170–1179

    Article  PubMed  Google Scholar 

  15. Walker N, Michaud K, Wolfe F (2005) Work limitations among working persons with rheumatoid arthritis: results, reliability, and validity of the work limitations questionnaire in 836 patients. J Rheumatol 32:1006–1012

    PubMed  Google Scholar 

  16. Zhang W, Bansback N, Guh D, Li X, Nosyk B, Marra CA, Anis AH (2008) Short-term influence of adalimumab on work productivity outcomes in patients with rheumatoid arthritis. J Rheumatol 35:1729–1736

    PubMed  Google Scholar 

  17. Gilworth G, Chamberlain MA, Harvey A, Woodhouse A, Smith J, Smyth MG, Tennant A (2003) Development of a work instability scale for rheumatoid arthritis. Arthritis Rheum 49:349–354

    Article  PubMed  Google Scholar 

  18. Gilworth G, Emery P, Gossec L, Vliet Vlieland TP, Breedveld FC, Hueber AJ, Schett G, Tennant A (2008) Adaptation and cross-cultural validation of the RA-WIS (Work Instability Scale). Ann Rheum Dis. doi:10.1136/ard.2008.098921

    PubMed  Google Scholar 

  19. Verstappen SM, Hoes JN, Ter Borg EJ, Bijlsma JW, Blaauw AA, van Albada-Kuipers GA, van Booma-Frankfort C, Jacobs JW (2006) Joint surgery in the Utrecht Rheumatoid Arthritis Cohort: the effect of treatment strategy. Ann Rheum Dis 65:1506–1511

    Article  PubMed  CAS  Google Scholar 

  20. Louie G, Ward M (2009) Changes in the rates of joint surgery among patients with rheumatoid arthritis in California, 1983–2007. Ann Rheum Dis. doi:10.1136/ard.2009.112474

    PubMed  Google Scholar 

  21. Jacob-Tacken KHM, Koopmanschap MA, Meerding WJ, Severens JL (2005) Correcting for compensating mechanisms related to productivity costs in economic evaluations of health care programmes. Health Econ 23:47–54

    Google Scholar 

  22. Wolfe F, Michaud K, Choi HK, Williams R (2005) Household income and earnings losses among 6, 396 persons with rheumatoid arthritis. J Rheumatol 32:1875–1883

    PubMed  Google Scholar 

  23. Westhovens R, Boonen A, Verbruggen L, Durez P, De Clerck L, Malaise M, Mielants H (2005) Healthcare consumption and direct costs of rheumatoid arthritis in Belgium. Clin Rheumatol 24:615–619

    Article  PubMed  CAS  Google Scholar 

  24. Lapsley HM, March LM, Tribe KL, Cross MJ, Courtenay BG, Brooks PM, Arthritis Cost and Outcome Project Group (2002) Living with rheumatoid arthritis: expenditures, health status, and social impact on patients. Ann Rheum Dis 61:818–821

    Article  PubMed  CAS  Google Scholar 

  25. Curkendall S, Patel V, Gleeson M, Campbell RS, Zagari M, Dubois R (2008) Compliance with biologic therapies for rheumatoid arthritis: do patient out-of-pocket payments matter? Arthritis Rheum 59:1519–1526

    Article  PubMed  CAS  Google Scholar 

Download references

Conflicts of interest

The content of this article is the sole responsibility of the author. Medical writing assistance for the preparation of this article was provided by Synergy who received financial support from Pfizer. A. Boonen has received honoraria from Abbott and Pfizer for speaking and consulting.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Annelies Boonen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Boonen, A., Severens, J.L. The burden of illness of rheumatoid arthritis. Clin Rheumatol 30 (Suppl 1), 3–8 (2011). https://doi.org/10.1007/s10067-010-1634-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-010-1634-9

Keywords

Navigation