Key clinical point: Life expectancy increased for RA patients after the adoption of biologics, but an average loss of life expectancy of nearly 5 years persisted when compared with controls.

Major finding: The lifetime cost of RA was estimated at $72,953 (U.S. dollars) after the availability of biologics.

Study details: The data come from a review of 29,352 new cases of RA between 2003 and 2016 based on claims from the National Health Insurance of Taiwan.

Disclosures: The study was supported by the Ministry of Science and Technology, Taiwan, and China Medical University Hospital. The researchers had no financial conflicts to disclose.

Commentary

“The burden of RA for patients and the healthcare system is a large one, encompassing potential pain, disability, functional impairment, and costs. The advent of biologic DMARDs about 20 years ago allowed for improvement in disease activity in many RA patients. This cohort study from Taiwan compares mortality and costs (medical expenditures) after 2003, when biologics became available. Incident cases of RA (as ascertained by ICD codes) diagnosed after 2003 were analyzed and compared to a reference population of healthy controls matched by age, sex, and calendar year. Life expectancy was extrapolated via a model and expressed as “loss of life expectancy” compared to the control group. “Expected lifetime cost” of RA was also calculated based on reimbursement data from the national health insurance database. These extrapolations, while interesting, are not compared to information about costs and life expectancy prior to 2003; thus, whether RA patients live longer with higher lifetime expenditures is not clear.”

Arundathi Jayatilleke, MD

Lewis Katz School of Medicine, Temple University