Sources: Painful Realities: The economic impact of arthritis in Australia in 2007 by Arthritis Australia
Australian Institute of Health and Welfare, Bulletin 116, May 2013
There is a paucity of data related to rheumatoid arthritis (rheumatoid disease). Data is subsumed within the wider disease category of arthritis.
Across all disease categories in Australia the prevalence of arthritis ranks above mental health and cardiovascular disease. In terms of expenditure, arthritis ranks sixth below cancer and cardiovascular disease.
Expenditure on arthritis in Australia is growing rapidly. Over the last three years, Access Economics estimates that allocated arthritis health expenditure has grown by around 42%.
According to the 2007–08 National Health Survey (NHS), an estimated 428,000 Australians reported having rheumatoid arthritis. With approximately 2% of the population affected, rheumatoid arthritis is the second most common type of arthritis, after osteoarthritis. Rheumatoid arthritis can develop at any age and the condition is 1.6 times as common in women as in men.
In 2007, Access Economics estimates that there are 3.85 million Australians with arthritis, including 1.62 million with OA and 0.51 million with RA.
By 2050, it is projected there will be 7 million Australians with arthritis - 23.9% of the projected population of 29.4 million. This is forecast to include 3.3 million males (22.5% of males) and 3.7 million females (25.2% of females). RD is projected to increase to 3.1% of the population by 2050, affecting 904,000 Australians.
Access Economics estimates that in 2007, the allocated health system expenditure associated with arthritis is $4.2 billion - $1,100 per person with arthritis. Health expenditure on RA was estimated at $422 million. The largest component of health system cost was hospitals, which accounted for 44% of total allocated expenditure. Aged care homes and pharmaceuticals were also significant components, representing 23% and 14% of allocated expenditure respectively. Health expenditure on arthritis exceeded that on coronary heart disease, depression, stroke, diabetes and asthma.
Other financial costs resulting from arthritis are estimated to be $7.6 billion in 2007. Over half of this was productivity costs, reflecting the reduced employment rates and increased absenteeism that results from arthritic conditions. The costs of informal care were estimated to be over $1 billion in 2007, indicative of arthritis’ degenerative nature, and the need for individuals with the condition to be assisted and supported. People with arthritis may also require aids or devices to assist them in carrying out their daily activities, or make additions or modifications to their home to ensure safety and mobility. The cost of these is estimated to be $211 million in 2007.
Burden of Disease
The financial costs of arthritis are only one aspect of the total economic costs of arthritic conditions, the other, the non-financial component, is the burden of disease. The pain and suffering that arthritis patients endure as a result of their condition can decrease their quality of life, and while mortality rates for arthritis are low, there is also a cost in terms of years of life lost. In 2007 the years of life lost due to disease is an estimated 91,479 while the years of life lost due to premature death is estimated to be 2,376. Consequently, the total disability adjusted life years (DALYs) due to arthritis is estimated to be 93,855, or in dollar terms, the net cost of loss of wellbeing is $11.7 billion in 2007.
In 2005, the employment rate among the working age Australian population was 71.2%. After standardising for age and gender, the difference between employment rates for those with arthritis and the overall population was estimated to be 5.5% for men and 3.75% for women. Given average weekly earnings for each respective age group, the annual cost of lost earnings due to workplace separation and early retirement due to arthritis is estimated as $3.7 billion in 2007.
It is estimated that of those with arthritis who are in the working age population and currently employed, 16% will take time off work due to their condition. Access Economics estimates that in 2007, the total cost of absenteeism due to arthritis is $304 million. This includes $258 million in absences from paid work and $46 million in reduced productivity at home.
In 2007, additional search and hiring costs are estimated as $18,400 for people with arthritis, based on the present value of bringing forward three years of average cost of staff turnover (26 weeks at AWE).
Access Economics estimates that in 2007, $1.31 billion of potential taxation revenues will be lost due to the reduced participation of people with arthritis in the paid workforce.
Rheumatoid arthritis can be a significant cause of disability and have considerable impact on quality of life. According to the 2007–08 NHS, people with rheumatoid arthritis were:
The cost of welfare reliance from all sources of public welfare due to arthritis is estimated at $1.20 billion per annum in 2007.
Access Economics estimates that in 2007, the cost of government programs attributable to arthritis is estimated as $256 million.
About 17% of arthritis sufferers register a disability. Overall, the cost for aids and equipment for people with arthritis was an estimated $220 million in 2007 – $57 per person with arthritis.
Who Bears The Cost
The greatest share of arthritis costs in Australia is borne by the individuals with arthritis themselves who, principally due to the large burden of disease costs, bear 61% of total costs. 21% of total costs are borne by the Federal Government due to the high health system and productivity costs, while a further 9% are borne by society at large.