For Employers, Rheumatoid Arthritis Cost Overshadows Incidence

August 18, 2020
Skylar Jeremias

Employers could save thousands of dollars by promoting the use of biosimilars that will keep employees with rheumatoid arthritis from having to file for disability, according to Brian Gifford, PhD, research director of the Integrated Benefits Institute.

Rheumatology biosimilars can increase workplace productivity and help employers save by reducing the amount of disability claims filed by employees with rheumatoid arthritis (RA), according to Brian Gifford, PhD, research director of the Integrated Benefits Institute (IBI), in a webinar hosted by the Pacific Business Group on Health and IBI.

“When IBI thinks about health and productivity, we think about absence and disability. Musculoskeletal conditions are really front and center here, but when thinking about [RA]…only 1% of the employed population reports treatment for [RA]. So, it's not always front and center for an employee or employers,” noted Gifford.

Gifford explained that although the percentage of employees who receive treatment for RA is low, the cost for those treatments can result in employers having excess medical and sick day costs of $7500 for employees with RA, which is 3 times as high as for employees with back pain ($2430).

On the positive side, Gifford said that short-term disability claims are rare (9 claims per 100,000 covered lives), showing that current treatments for RA, such as biosimilars and other biologic medications, are working to keep people out of the disability system.

“There's a savings associated with these treatments that I don't think is always going to get captured in the costs. So, it's a difference between looking at returns on investment versus value on investment,” said Gifford.

Short-Term Disability Burdens

However, Gifford said these estimates are on the low end as it can take employees a long time to receive an RA diagnosis or their inflammatory condition may have been misdiagnosed, resulting in them being added to the disability system. Factoring those who receive disability benefits and whose conditions have been misdiagnosed into the RA disability claim rate could quadruple the number per 100,000.

Disability leave can cause a heavy burden for employers because short-term disability claim costs for RA are an average of $6900, which is more than for osteoporosis, back pain, and other musculoskeletal conditions, according to Gifford.

Additionally, 19% of short-term disability claims for RA are converted to long-term disability claims, which Gifford said is revealing.

“If effective treatments are keeping a lot of time people out of the short-term disability system then, the ones that are getting in probably have unmanaged [RA]. And that's why we see about 1 in 5 going into long-term disability,” he noted.

Gifford said that employers should think about how their policies and formularies actually help employees return to the workplace, because that is what they ought to do.

“I think this is really going to be the best way for biosimilars, biologics, and all kinds of different therapies to not just keep employers’ cost growth flat, but to actually contribute to business performance, because people who are well managed are better able to attend work consistently and put in a good performance on the job. Everybody's better off,” said Gifford.

Long-Term Disability Burdens

Gifford said that 60% of long-term disability claims for patients with RA are active for more than 2 years, which indicates that many may not return to their jobs.

“Keeping people with [RA] out of the disability system is going to be critical because those people, all of their skills, and all their experience could be lost to the labor force and could have a really big impact, of course, on their own lives, in terms of wage losses and so on,” said Gifford.

Long-term disability claims for RA cost employers on average $64,870, more than double what it costs for other musculoskeletal conditions ($31,135) and almost triple that for osteoarthritis ($26,215), according to Gifford.

The United States has reached the 4-year anniversary of having an infliximab biosimilar for RA, but significant barriers to uptake still exist. Read an insightful column about this by Sonia T. Oskouei, PharmD, BCMAS, DPLA, the vice president of Biosimilars for Cardinal Health.