Economic Burden

Economic Burden of Treating Rheumatoid Arthritis in USA and Europe

The financial impact of rheumatoid arthritis (RA) is substantial for health-care systems and society worldwide, creating significant economic burdens through both direct and indirect costs.

United States Costs

In the US, healthcare costs associated with RA were estimated at $4422 in 2004, $2902 in 2005, and $1882 in 2006. Beyond direct medical expenses, RA significantly impacts income and productivity. RA reduced income by $2404 in 2004, $2207 in 2005, and $1212 in 2006. Employment rates for RA sufferers were significantly lower than the general population: 36.8% in 2004, 39.5% in 2005, and 44% in 2006, compared with approximately 70% in the general population.

Historically, the total annual direct costs of RA were calculated to be $US5275 and $US6099 (1991 dollars) per patient, with lifetime medical care charges estimated at $US12,578 per patient. A 2001 study found the average monthly cost of care was $853, of which $294 (34%) was for RA-coded medical services.

For patients using TNF inhibitors, those with treatment persistence ≥80% had higher mean total health care costs compared with those with lower persistence ($19,271.52 vs $15,598.46), largely due to higher pharmacy costs.

European Costs

In Europe, TNF-alpha blocking agents such as etanercept and infliximab have high annual therapy costs of 17,000-21,000 Euro compared to annual costs of 350-5000 Euro for other disease-modifying drugs (DMARDs).

A 2003 Spanish study found that for pharmaceuticals exclusively for RA, annual cost was 342.8 € excluding anti-TNF therapy. When including all patients with anti-TNF therapy, gastro-protection and co-morbid situations, the mean cost was 2,587 € per year.

In Sweden, the cost per QALY gained for infliximab treatment was SEK 32,000 (€3,440) for 1 year and SEK 150,000 (€16,100) for 2 years. In the UK, these figures were GBP 21,600 (€34,800) for 1 year and GBP 29,900 (€48,200) for 2 years.

A 2002 Dutch study found that treatment with infliximab is more expensive than etanercept with total costs of NLG 45,115 (18,046 US dollars) and NLG 31,621 (12,648 US dollars), respectively.

Cost Drivers and Trends

Drug costs comprise the main component (up to 87%) of direct costs with an increasing trajectory over time. The proportion of costs for hospitalization has shown a statistically significant decrease chronologically.

Indirect costs, primarily associated with absenteeism and work disability, account for 39% to 86% of total costs. Work disability remains the main component of indirect costs.

Recent studies show more promising results of about $12,000/QUALY and even cost savings per QUALY administering etanercept and infliximab, respectively. However, the wide range of cost-effectiveness ratios is mainly explained by different methodological approaches.

Economic analyses that do not incorporate or appropriately measure indirect costs will underestimate the full economic impact of RA.

Company drugs in pipeline

AleraCare and PURE Healthcare Drug Pipeline Indications

After a thorough examination of available information, there is insufficient data to provide details about the drug pipeline indications for AleraCare and PURE Healthcare.

The pharmaceutical development programs of these companies, including their drug candidates and targeted therapeutic areas, are not documented in the available information. Without specific details about their pipeline drugs, it is not possible to outline which medical conditions or disease targets they are addressing.

For comprehensive information about AleraCare and PURE Healthcare's investigational drugs and their developmental stages across various therapeutic indications, direct consultation of the companies' official resources would be necessary. This might include their corporate websites, investor relations materials, or regulatory filings that would contain details about their drug development activities.

Understanding a company's pharmaceutical pipeline typically involves analyzing information about:

• Early-stage candidates in preclinical development
• Clinical-stage assets undergoing Phase I, II, or III trials
• Target indications for each drug candidate
• Mechanism of action of pipeline compounds
• Therapeutic areas of focus
• Development timelines and milestones
• Collaborative partnerships in research and development

Companies like AleraCare and PURE Healthcare would normally publish such information to inform stakeholders about their progress in addressing unmet medical needs through their pharmaceutical research efforts.