Direct Costs to Patients for RA Treatment: $12,509-$36,053

November 20, 2020
Rheumatology Network Editorial Staff

The annual direct costs for rheumatoid arthritis (RA) patients are estimated to range from $12,509-$36,053. A late diagnosis costs even more and one in 10 new RA cases are usually diagnosed late. In this presentation, Kathryn Johnson, RPh, of CVS Health breaks down the numbers.


Kathryn Johnson, RPh, serves as Director of Specialty Innovation and Product Development, CVS Health, Lincoln, Rhode Island.

In this video, Ms. Johnson provides an overview of a presentation she made at the American College of Rheumatology annual meeting: "Medical Savings of Timely Rheumatoid Arthritis Diagnoses," abstract number 0576, Sat., Nov., 7, 2020.

"To stop or slow the progression, it is ideal if the rheumatoid arthritis or RA diagnosis occurs within six months of the appearance of symptoms. While previous studies suggest that RA recognition and treatment provides greater clinical benefits than treatments started later in the disease course, the impact of early treatment initiation on the total cost of care in RA patients has not been well studied.

The purpose of this study was to determine the medical cost savings of a timely RA diagnosis six months pre- and post diagnosis. We found that annual direct costs for RA patients are estimated to range from $12,509-$36,053. A late diagnosis―categorized as patients who are diagnosed in an emergency department or in patient setting―was associated with significantly higher total cost of care compared to a timely RA diagnosis. One in 10 new RA cases were categorized as late diagnosis and contributes to over $4,000 in medical spending per patient per year in commercial populations.

Prior to diagnosis in-patient visits drove an increase in cost of care per plan per member over six months. The total cost of care per member per year per new RA patients diagnosed in an emergency department, or in patient setting, was significantly higher than new RA patients diagnosed in other settings.

This research highlights gaps in total diagnosis of rheumatoid arthritis, which is one of the most common autoimmune diseases that could help address cost and patient outcomes.

Our research unearthed valuable insights about the financial implications of a timely RA diagnosis that can help encourage further research to identify patients at risk for rheumatoid arthritis and appropriate interventions that will help to further reduce avoidable healthcare costs.

Thank you for the opportunity to present today."