Long-term morbidity, mortality, and economics of rheumatoid arthritis

Arthritis Rheum. 2001 Dec;44(12):2746-9. doi: 10.1002/1529-0131(200112)44:12<2746::aid-art461>3.0.co;2-z.


Objective: To estimate the morbidity, mortality, and lifetime costs of care for rheumatoid arthritis (RA).

Methods: We developed a Markov model based on the Arthritis, Rheumatism, and Aging Medical Information System Post-Marketing Surveillance Program cohort, involving 4,258 consecutively enrolled RA patients who were followed up for 17,085 patient-years. Markov states of health were based on drug treatment and Health Assessment Questionnaire scores. Costs were based on resource utilization, and utilities were based on visual analog scale-based general health scores.

Results: The cohort had a mean age of 57 years, 76.4% were women, and the mean duration of disease was 11.8 years. Compared with a life expectancy of 22.0 years for the general population, this cohort had a life expectancy of 18.6 years and 11.3 quality-adjusted life years. Lifetime direct medical care costs were estimated to be $93,296. Higher costs were associated with higher disability scores.

Conclusion: A Markov model can be used to estimate lifelong morbidity, mortality, and costs associated with RA, providing a context in which to consider the potential value of new therapies for the disease.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / drug therapy
  • Arthritis, Rheumatoid / economics*
  • Arthritis, Rheumatoid / mortality*
  • Cohort Studies
  • Disability Evaluation
  • Female
  • Health Care Costs
  • Humans
  • Life Expectancy
  • Male
  • Markov Chains
  • Middle Aged
  • Morbidity
  • Outcome Assessment, Health Care / economics
  • Product Surveillance, Postmarketing
  • Quality-Adjusted Life Years
  • Surveys and Questionnaires


  • Antirheumatic Agents