Rheumatoid arthritis (RA) is a musculoskeletal condition that affects about 1% of Canadians. If RA is not diagnosed early and treated properly, it can place a heavy financial burden on plan sponsors.
RA is a chronic autoimmune disease characterized by inflammation in the lining of the joints. It is a systemic disease, which means it can cause severe fatigue and affect other parts of the body. It develops in about 1% of the world’s population, and it tends to strike people when they are 35 to 50 years old, the prime working years.
There is no question that this disease can have significant negative consequences in the workplace. Whether through absenteeism, presenteeism or disability costs, there will be an impact on the company’s bottom line on some level. In 2006, the American College of Occupational and Environmental Medicine reported that the average total costs for workers with RA were US$4,244 greater than for workers without RA.
Advances in technology have allowed for more targeted means of treating RA and can send people into remission and back to work sooner. Biologics, which are genetically engineered proteins derived from human genes, are designed to slow down certain areas of the immune system that stimulate inflammation, a primary characteristic of RA. In other words, they work by targeting specific components of the immune system instead of broadly affecting many areas of it.
Aggressive treatment of RA with disease modifying anti-rheumatic drugs (DMARDs) is effective at preventing joint damage and improving physical function, especially when they are used early, when the disease is more responsive to treatment. Although biologics are more expensive than traditional DMARDs, they are effective alternatives for people with moderate or severe RA who fail to respond to traditional DMARDs. Research has shown that biologics slow the progression of RA and prevent long-term disability. Studies have shown that employees who are treated with biologics not only take less time off work but are also more productive.
Plan sponsors should design their benefits plan to facilitate the best patient outcomes for the lowest cost; only in this way will they maximize productivity and minimize their costs. Employees with RA that’s treated aggressively and efficiently have optimal chances of leading a relatively normal and fully productive life at home and at work.
Dr. Diane Lacaille is an associate professor with The Arthritis Research Centre at the University of British Columbia.
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