INDIRECT AND NONMEDICAL COSTS AMONG PEOPLE WITH RHEUMATOID-ARTHRITIS AND OSTEOARTHRITIS COMPARED WITH NONARTHRITIC CONTROLS

Objective, Compared to rheumatoid arthritis (RA), osteoarthritis (OA) is considered much more benign and much less costly. We sought to desc ribe the economic effects of RA and OA, in terms of the indirect and n onmedical expenditures, compared to nonarthritic controls. Methods, Us ing our unique population based data resources, we developed a model f or estimating and comparing disease specific costs among 2 randomly se lected, community based samples of 200 patients each with RA and OA an d a control group of 200 individuals from the same community who do no t have arthritis. Data were collected using a pretested postal survey. Age and sex adjusted comparisons were conducted across the 3 groups, and predictors of cost and utilization were identified using logistic regression modeling. Results, There were 123, 116, and 94 respondents among the RA, OA, and nonarthritis groups, respectively. The average a ge and the female-to-male ratios were higher in the OA and RA groups c ompared to the nonarthritis group. Patients with RA and OA required 3 times more days of care for their conditions compared to nonarthritics (p < 0.0001) and incurred significantly more expenditures for home or child care (p = 0.01) and other services (p = 0.001) (i.e., medical e quipment, assistive devices, or home remodeling) compared to nonarthri tics. In addition, patients with RA were significantly more likely to have lost their job or to have retired early due to their illness (p = 0.001); were the most likely to have reduced their work hours or stop ped working entirely due to their illness (p = 0.003); and were 3 time s more likely to have had a reduction in household family income than either individuals with OA or those without arthritis (p = 0.0001). Fi fteen percent of respondents with RA were unable to get a job because of their illness, while 3% of respondents with OA and only 1% of nonar thritic respondents reported this experience (p = 0.001). Logistic reg ression analysis revealed that functional status and pain score, as we ll as the presence of either RA or OA, were significant predictors of cost and health services utilization. Conclusion, Disease specific ind irect and nonmedical costs for OA are substantial and approach those f or RA. This has important societal implications, given the high preval ence of OA.