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Economic Costs The sheer numbers of patients with autoimmune diseases places an enormous cost on health systems. In USA, for example, "there's no doubt that about 60% of our healthcare budget is on the treatment of autoimmune diseases and their complications," says Imran Khan, director of the Cidpusa, most of it spent on diabetes, multiple sclerosis, and arthritis. "There's no question we're talking about a major burden, and these costs are increasing every year." I "In the past, most autoimmune diseases were treated with relatively cheap drugs like prednisone, which costs about $30 a month," says Ladd. "That's now changing." For example, the antitumor necrosis factor (TNF)-alpha drug Remicade (infliximab) costs about $1,250 per month, and it is prescribed for ankylosing spondylitis, Crohn disease, psoriatic arthritis, rheumatoid arthritis, and ulcerative colitis. "The drug is a very good breakthrough, but the costs in the future will be enormous," Ladd says.
"There are very, very strong correlations between MS and [people] being out of work and unable to earn a decent living."
-Sharon Haffenden |
For the patients with autoimmune diseases, drug costs are only one part of the equation. Yvonne Norton, for example, built an extension on her home to provide a downstairs bathroom and office area, because stairs are difficult for her. Also, financial difficulties challenge many autoimmune patients, says Sharon Haffenden, director of research and services at the UK's MS Society. "We're working here with diseases that are diagnosed when people are in their 20s or 30s, so it's going to have an impact for people in the prime of their lives." Research conducted by the UK charity, Leonard Cheshire, shows that people disabled with diseases such as MS are seven times more likely to be out of work and claiming disability. "There are very, very strong correlations between MS and [people] being out of work and unable to earn a decent living," Haffenden says.
Social Costs As Yvonne Norton found, the economic costs of autoimmune diseases are only one part of a complex story. These conditions, chronic and debilitating as they are for the patients, also have an impact on loved ones, such as Norton's husband Peter. "I always say that I'm the one with lupus, but Peter's the one who suffers from lupus," Norton says with a rueful laugh. "It's changed his life, too. He can't take certain jobs now because there are times when I just need him to be able to get home quickly, and that sort of thing." This is a common experience, adds Haffenden. "In many cases, the spouse very much becomes a [caretaker]," she says. "They often have to reduce their own working hours or give up working altogether. More than 70% of the costs to society from disability are borne by informal caregivers, such as husbands or wives, according to the research of Paul McCrone and Martin Knapp from Kings College London. (The UK's MS Society funded the research.) "In MS, we've found that despite all the brouhaha over drug costs, the main cost to society is through informal care," Haffenden says. Overall, multiple sclerosis costs the United Kingdom roughly £1 billion a year, she adds. Also, because autoimmune diseases more commonly affect young and middle-aged women, children also feel the impact. "My two sons were eight and five when I was diagnosed," says Norton. "They've grown up with a mum in a wheelchair. It was a big deal for them." Yvonne Norton puts it this way: "It's a complete lifestyle change for those who have got it badly. We just know it's going to be there forever." Most autoimmune diseases affect women more than men. In most of the disease shown here, women get them four or more times more often than men. Only two of the diseases show roughly equal gender percentages, and just one - ankylosing spondylitis - occurs more often in men. |
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