The economic burden associated with OA, RA, and hypertension: a comparative study

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Ann Rheum Dis. 2004 Apr;63(4):395-401.

The economic burden associated with osteoarthritis, rheumatoid

arthritis, and hypertension: a comparative study.

Maetzel A, Li LC, Pencharz J, Tomlinson G, Bombardier C.

Division of Clinical Decision Making and Health Care Research,

University Health Network Research Institute, Toronto, Ontario, Canada.

Department of Health Policy, Management and Evaluation, University of

Toronto, Ontario, Canada. The Arthritis Society, Ontario Division,

Toronto, Ontario, Canada. Department of Medicine, University of Toronto,

Ontario, Canada. Department of Public Health Sciences, University of

Toronto, Ontario, Canada. Mt Sinai Hospital, Toronto, Ontario, Canada.

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.

PMID: 15020333

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