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The Cost of Rheumatoid Arthritis

Reviewed by Jennifer Robinson, MD on October 06, 2020

Rheumatoid arthritis (RA) is a chronic disease in which the immune system mistakenly attacks the body, including the joints. It can also affect other organs, such as the heart, lungs, and eyes. RA is two to three times more common in women than in men.

Though there is no cure, there are a variety of treatments that may be prescribed for an RA patient, including:

The expenses involved with these treatments can add up. Depending on what your health insurance covers, you may end up paying a large amount out of pocket. It’s not uncommon for RA patients to pay up to $30,000 every year for medication. And even though health insurance may cover part of the costs, you may have to pay out of pocket as much as 30% of the cost of your drugs.

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Specific drug costs may include:

  • DMARDs, or disease-modifying antirheumatic drugs, cost most patients between $1,500 and $2,000 each year, depending on the medication.
  • Biologics, a new type of RA treatment, generally must be given by a health care professional, and they’re pricey, running $1,300 to $3,000 per month.

If medications aren’t enough, surgery may be necessary. Some people with RA need a joint replacement or arthroscopic surgeries, which can cost tens of thousands of dollars. The average price for an inpatient knee replacement, for example, is approximately $30,249, according to numbers from Blue Cross Blue Shield.

After surgery often comes more payments for physical therapy, assistive devices, or medications. Therapy to help deal with the emotional impact of having a chronic disease can also add to the costs. So can any complementary therapies you try, such as acupuncture.

Indirect Costs

These aren’t for medications or other treatments. Examples include money lost if you can’t work full-time due to your RA. The Rheumatoid Arthritis Support Network estimates that low productivity, absenteeism, and lost wages can cost $1,500 to $22,000 per year, per patient.

Even if you have Medicare, RA costs are a burden. In one study, RA patients with Medicare paid more than twice as much in annual health care costs than Medicare patients without RA.

Tips to Manage RA Costs

Although RA expenses are high, you may be able to make them more manageable. Try one or more of the following tactics:

Look into assistance programs. You may qualify for help from an organization that offers financial aid to people with certain diagnoses. The Arthritis Foundation has a list of consumer assistance programs on its website.

Call the manufacturer. Drugmakers frequently offer programs or discounts that will let you buy their medications for less.

Try NeedyMeds.NeedyMeds is a nonprofit that offers to connect consumers with programs that can help them pay for medications and other health care expenses. You can type in the name of your medication, and the site will tell you if there are any programs that can help with the cost.

Get secondary insurance to go with Medicare. If you have Original Medicare, you can purchase a Medicare Supplement (Medigap) plan that offers extra help with out-of-pocket costs.

Compare prices on prescriptions. All pharmacies aren’t created equal, and you may find that one local pharmacy has a better price on a medication than another. Use websites to check local prices in your area. You may also consider mail-order prescriptions for long-term medications --prices are usually less, either because the medication price is lower or because you only owe one copay for a 3-month supply.

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Ask your doctor’s office or hospital. Medical offices or health care centers often staff care coordinators who can help you manage your care -- which includes questions about medication costs and insurance claims.

Managing your RA costs can be overwhelming, but there are ways to lower your annual bills. Talk to your rheumatologist if you have concerns about paying for treatment.

WebMD Medical Reference

Sources

SOURCES:

Global RA Network: “About Arthritis and RA.”

CDC: “Rheumatoid Arthritis (RA).”

Rheumatoid Arthritis Support Network: “RA Facts: What are the Latest Statistics on Rheumatoid Arthritis?” “RA Treatment Costs: What are the Costs of RA Medications and Surgery?” “RA Costs: What are Payment Options for Treating Rheumatoid Arthritis?”

Blue Cross Blue Shield: “Planned knee and hip replacement surgeries are on the rise in the U.S.”

Rheumatology Advances in Practice: “Burden of rheumatoid arthritis among US Medicare population: co-morbidities, health-care resource utilization and costs.”

Arthritis Foundation: “Consumer Assistance Programs.”

Medicare.gov: “What’s Medicare Supplement Insurance (Medigap)?”

Kaiser Permanente: “Reducing Medication Costs.”

CHI Health: “Care Coordinators.”

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