Arthritis is one of the most prevalent chronic conditions in Canada and one of the leading causes of disability and health care utilization. The aging of the Canadian population has led to an epidemiological shift in disease profile, resulting in illnesses such as arthritis becoming one of the biggest challenges facing society. Prevalence projections suggest that by 2010 over 4.4 million Canadians will have osteoarthritis (OA) and over 272,200 will have rheumatoid arthritis (RA), representing 13.0% and 0.8% of the Canadian population, respectively.
By 2010 the growing burden on health care and social service systems in Canada is estimated to be $10.2 billion and $2.4 billion in direct health care costs for OA and RA alone while the total economic burden of OA and RA including direct and indirect costs is estimated to be over $27.5 billion and $5.6 billion dollars, respectfully. The life and economic consequences of OA and RA will be further magnified over the next 30 years due to the expected increase in the number of people living with OA (over 6 million) and RA (over 276,900). As a result of the increasing number of people living with OA and RA, the economic burden associated with the disease is also expected to increase; the cumulative total economic burden of OA and RA is expected to be over $1.4 trillion and $257.4 million dollars, respectively over 30 years.
The objective of this study was to estimate the health and economic burden of OA and RA in Canada over the next 30 years and assess the impact of arthritic-care interventions on reducing this burden.
Using RiskAnalytica’s Life at Risk® simulation model, measures of incidence, prevalence and mortality using input data on OA, the most common form of arthritis and RA, the most prevalent form of inflammatory arthritis, were simulated to estimate the burden of disease over a 30 year time horizon.
The Interventions: Four intervention scenarios were identified via consensus workshops held with the Alliance for the Canadian Arthritis Program (ACAP) members including epidemiologists, researchers, clinicians and government and patient representatives. The interventions were used to simulate to simulate the potential impacts of arthritis prevention and treatment programs and included the following:
1. DMARD and Biologic Use: the impact of early treatment and access to DMARDs and biologics on RA disability and arthritis-attributable costs.
2. Total Joint Replacement Surgery: the impact of total hip and knee joint replacement surgeries on OA disability and arthritis-attributable costs;
3. Pain Management: the impact of hypothetical pain management strategies on OA costs; and
4. Primary Prevention: the impact of a hypothetical weight reduction program, on OA incidence that aims to reduce the proportion of obese Canadians by 50%."