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FAQs (Data Related) Cost Analysis

  1. What is the national cost of arthritis and other rheumatic diseases (AORC) for the United States?
  2. How are the costs of arthritis and other rheumatic diseases (AORC) at the state level determined?
  3. Does the CDC recommend using Medicare and Medicaid data for arthritis surveillance?
  4. Does the CDC recommend using pharmacy data for arthritis surveillance or to make cost estimates?

  1. What is the national cost of arthritis and other rheumatic diseases (AORC) for the United States?

    In 2003, arthritis and other rheumatic conditions (AORC) cost the United States $127.8 billion ($80.8 billion in medical care expenditures and $47.0 billion in lost earnings). The total national costs of $127.8 billion were 1.2% of the Gross Domestic Product, which is equal to a chronic, small recession. These are the most recent U.S. population-based cost estimates for AORC and were generated from the Medical Expenditure Panel Survey, a nationally representative survey conducted annually.

    You can learn more about the national cost estimates in the following MMWR publication. (Yelin E, Cisternas M, Foreman A, Pasta D, Murphy L, Helmick C. National and state medical expenditures and lost earnings attributable to arthritis and other rheumatic conditions — United States, 2003. Morbidity and Mortality Weekly Report 2007;56(1):4–7.

    A more detailed report on how the national cost estimates were derived, and comparisons between 1997 and 2003 was published: Yelin E, Murphy L, Cisternas MG, Foreman AJ, Pasta DJ, Helmick CG. Medical Care Expenditures and Earnings Losses Among Persons with Arthritis and Other Rheumatic Conditions in 2003, and Comparisons with 1997. Arthritis and Rheumatism 2007;56(5):1397–1407.

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  2. How are the costs of arthritis and other rheumatic diseases (AORC) at the state level determined?

    There are insufficient state-specific data to accurately estimate the costs attributable to AORC for all 50 states, therefore we used national data to calculate state-level costs.

    We generated 2003 national arthritis cost estimates using data from the 2003 Medical Expenditure Panel Survey. Then we estimated each state's direct arthritis costs by apportioning the national arthritis direct cost estimate by each state's proportion of the overall (i.e., 50 states and District of Columbia) arthritis burden (i.e., using the proportion of doctor-diagnosed arthritis prevalence for each state from the 2003 BRFSS survey). For example, if a state had 2.5% of the overall prevalence of doctor-diagnosed arthritis, it would have 2.5% of the national direct costs. We used the same approach to estimate state-level indirect costs (that is, apportioned the national interest estimate by each states proportion of the overall arthritis burden).

    Studies of other conditions have used different methods to estimate direct costs. For example, state-specific costs have been derived by applying the national attributable fractions for the condition to National Health Account state level cost data. We believe this approach and others can result in a sizeable overestimate of state costs.

    Medical expenditures and lost earnings for each state are presented in the following MMWR publication. Yelin E, Cisternas M, Foreman A, Pasta D, Murphy L, Helmick C. National and state medical expenditures and lost earnings attributable to arthritis and other rheumatic conditions — United States, 2003. Morbidity and Mortality Weekly Report 2007;56(1):4–7.

    The software for version 2 of the CDC Chronic Disease Cost Calculator has been completed. The calculator will provide state-level medical and indirect costs for a range of chronic conditions including arthritis, asthma, heart disease, stroke, cancer, and diabetes. Following a report describing the Calculator methods, the CDC Arthritis Program will publish the state-level cost estimates for arthritis in an MMWR; the MMWR publication date is likely mid-2012.

    NOTE: Technical assistance for the CDC Chronic Disease Cost Calculator is available.

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  3. Does the CDC recommend using Medicare and Medicaid data for arthritis surveillance?

    No. Dr. Ken Powell from the Georgia Department of Human Resources explored the use of these data (Powell E, Diseker A, Presley J, et al. Administrative data as a tool for arthritis surveillance: Estimating prevalence and utilization of services. Journal of Public Health Management and Practice. 2003 July;9(4); 291–298. He found one can obtain different answers, depending on 1) how variables are defined, 2) the number of years included, and 3) how enrollment is defined. He also found that using these data was very labor intensive and was difficult to justify.

    In the absence of a clear link to a project, or to your state arthritis plan, we recommend you do not analyze Medicaid or Medicare data, especially if it takes program resources.

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  4. Does the CDC recommend using pharmacy data for arthritis surveillance or to make cost estimates?

    No. One problem is that very few arthritis medications are used only for arthritis; most are used for other conditions as well. For example, some of the biologics can cost $15,000 to $20,000 a year and are used for other conditions like inflammatory bowel disease. This is an issue that needs to be further explored to determine the utility of these data.

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