Comorbidities in RA tied to higher healthcare spending, lower income, employment prospect

In patients with rheumatoid arthritis (RA), comorbidities tend to result in higher annual healthcare expenditure, lower likelihood of employment, higher rates of absenteeism, and lower income, according to a study. Heart failure (HF), despite its lower prevalence, is associated with the highest incremental expenditure and lowest chance of employment compared with other common comorbid conditions.

The authors performed a retrospective analysis of the Medical Expenditure Panel Survey from 2006 to 2015 in 4,967 adults with RA in the US to evaluate the effect of comorbidities on direct healthcare spending and work-related outcomes in this population. They used generalized linear models for healthcare expenditure and income, logistic models for employment status, and zero-inflated negative binomial models for absenteeism.

Overall, 13 comorbid conditions were considered as potential predictors of direct cost- and work-related outcomes. The models were adjusted for the following sociodemographic factors: age, sex, region, race/ethnicity, education, income, marital status, and smoking status.

RA patients with HF showed the highest incremental annual healthcare expenditure (US $8,205, 95 percent confidence interval [CI], $3,683–$12,726) compared to those without HF. Several comorbidities such as hypertension, diabetes, depression, chronic obstructive pulmonary disease, cancer, stroke, and HF also decreased the chance of RA patients aged 18–64 years to get a job.

On the other hand, absenteeism among employed RA patients significantly correlated with hypertension, depression, disorders of the eye and adnexa, or stroke. Of note, RA patients with HF earned an average US $15,833 (95 percent CI, $4,435–$27,231) per year less than RA patients without the comorbid conditions.