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New study shows rapid increases in the impact of arthritis on individuals, carers and taxpayers. The good news, according to the research is that investment in prevention and treatment is highly cost effective.

“The figures are stark,” claims Dr Mona Marabani, President of Arthritis Australia who commissioned the study. “Just under four million Australians have arthritis and if you’re over 80, the chances of having arthritis are one in two. Of the $24 billion that arthritis costs each year in health care, lost time at work, shortened lives and years spent with disability, more than 60% is borne by the people with arthritis themselves,” says Dr Marabani who is a practising rheumatologist.

“This won’t surprise anyone who lives with arthritis,” says Judith Nguyen who has severe rheumatoid arthritis. “People tend to think of the elderly when arthritis is mentioned but there are tens of thousands of young people who have it too. Without effective treatment we face pain, disability, psychological distress and – to be frank – financial hardship because of the effects on our ability to be productive members of the community.”

“We estimate that there are 3.85 million Australians living with arthritis in 2007. This is a rise of about 700,000 people in just six years,” says Lynne Pezzullo, a Director of Access Economics, who performed the study and who did a similar analysis in 2004 and 2001. “More than half of these people are of working age. And as far as costs are concerned, at $23.9 billion in 2007, it’s a $4 billion increase on our last estimate just three years ago.”

“Australia has several National Health Priorities, and arthritis was put on the list in 2002,” explains Dr Marabani. “But the Access Economics study shows that there are more people with arthritis than any of the other priority conditions. Yet because arthritis isn’t perceived to kill people, it’s not taken as seriously – and this must change.”

“I was diagnosed with rheumatoid arthritis 30 years ago. Fortunately I had an early diagnosis and, with the help of my GP, rheumatologist and family, began a lifelong management program. I’ve had seven joint replacements which have enabled me to work and live a fulfilling life. However, I have paid a price – personally and financially – as have my employers and the public and private healthcare systems,” says Judith Nguyen.

“The recent development of biologic medicines offers a more positive outlook for people recently diagnosed with inflammatory arthritis. Clinical evidence suggests their timely usage may arrest joint damage and consequent disability, allowing them to lead a meaningful life as well as avoid ongoing and costly health services,” she added.

“What the Access Economics study has shown unequivocally is that prevention strategies are possible and there are many cost effective treatments available, from joint replacement surgery to high technology medications which alter the immune system to pain relievers and obesity reduction,” argues Dr Marabani.

“Urgent attention must be given to reducing the physical, emotional, work-related and economic impacts of arthritis. A total support system must be implemented to ensure all Australians, irrespective of location and earning capacity, have access to prevention strategies and proper medical attention to manage symptoms and/or reduce joint damage. As well as the broader community, education and prevention must include Specialists, GPs, Pharmacists and allied health care professionals.

“The social and economic benefits are self evident: fewer adverse symptoms = improved quality of life = less national economic burden,” Dr Marabani added.

On the basis of this Report, Arthritis Australia is calling for three measures that will move things forward –

  • Building on resources and education programs for GPs and other health professionals so they have the knowledge to diagnose and refer early. As well, increased programs in rural/remote Australia to equip health professionals and patients in understanding and managing arthritis.
  • Medicare rebates for chronic disease management to be increased – for example, criteria to allow for more than five allied service visits (i.e. physiotherapists, occupational therapists, podiatrists, etc).And to allow tapping into private practitioners to meet the needs of people in the community – in the same way Medicare rebates have been provided for psychologists and social workers for people with depression. There are not enough physiotherapists and occupational therapists in the public sector to meet the demands of people with arthritis so we need to be able to use the resources of the private sector – to do this we need Medicare rebates.
  • There are some newer medications on the market which are highly effective – they can prevent joint damage in conditions like rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. Currently the criteria to allow PBS subsidy for these medications is very narrow which means that many people are missing out on access to them, risking unnecessary disability.

Background

Arthritis
There are over 100 different forms of arthritis but the most common are osteoarthritis (OA), which is largely due to wear and tear; gout, where crystals of a substance called uric acid are deposited in some joints like those in the big toe; rheumatoid arthritis (RA) and ankylosing spondylitis which are autoimmune conditions; and rarer forms of arthritis usually secondary to other problems like psoriasis.

Arthritis Australia
As the peak body for arthritis, Arthritis Australia is responsible for promoting awareness, early diagnosis and early intervention to improve and preserve sufferers’ quality of life. In collaboration with its state and territory Affiliates it is providing a range of awareness, education and support services, as well as managing a national arthritis research program. However, gaps in service delivery have been identified and action and funding is being sought to build capacity and reduce incidence and associated costs. Priorities include:

  • Increasing consumer knowledge of treatments available and improving access to allied health services
  • Ensuring quality use of medicines as well as access to appropriate medications to arrest joint damage
  • Strengthening capacity to meet consumer needs

Access Economics study: ‘Painful Realities’
This is an extensive economic analysis using a host of reliable data sources and research evidence and updates their last study done for Arthritis Australia in 2004.

  • In 2007, Access Economics estimates that there are 3.85 million Australians with arthritis (nearly 1 in 5 Australians), including 1.62 million with osteoarthritis (OA) and 0.51 million with rheumatoid arthritis (RA).
  • Overall, arthritis was more prevalent among women, with 19.9% of women estimated to have some form of arthritis in 2007 compared to 17.1% of men.
  • An estimated 61.3% of people with OA and 57.1% of people with RA are women.
  • 62% or 2.4 million of those with arthritis are in the working age population (15-64).
  • Prevalence rates among men are broadly correlated with age, peaking at 50% for the over-85s.
  • Obesity is an important risk factor for osteoarthritis; obese people are around 2.4 times as likely to have OA as people of normal weight, while overweight people are 35% more likely to have OA. Overweight is defined as a body mass index (BMI) of 25-30 and obesity as BMI over 30. BMI is the ratio of weight in kilograms to the square of height in metres.
  • If obesity continued to grow at the rates witnessed over the last ten years, by 2050, 46.6% of men and 34.8% of women would be obese.
  • Access Economics estimates that in 2007 the allocated health system expenditure associated with arthritis is $4.2 billion – $1,100 per person with arthritis.
  • In 2007, the total cost of arthritis is estimated to be $23.9 billion, of which almost half is the value of the loss of healthy life.
  • Access Economics estimates that in 2007 the total cost of informal care for people with arthritis is $1.01 billion. This equates to $262 per person with arthritis in 2007.