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J Clin Epidemiol. 1988;41(3):215-23.

The total cost of care and the use of pharmaceuticals in the management of rheumatoid arthritis: the Medi-Cal program.

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Center for Economic Studies in Medicine, Pracon Inc., Reston, VA 22091.


Medicaid claims data were analyzed to investigate the prevalence and cost of rheumatoid arthritis (RA) in the Medi-Cal program. It was estimated that approximately 24,000 Medi-Cal recipients receive treatment for RA each year. The sample of Medi-Cal RAs studied averaged more than $2500 annually in total direct health care expenditures. The total cost of RA to Medi-Cal is projected to be $19.26 million (+/- $0.90 million) annually. Inclusion of possible gastrointestinal side effects of drug therapy increases the total cost to $20.49 million (+/- $0.91 million). While only 6.5% of the sample of RAs were hospitalized and 4.9% received nursing home care annually, these services are estimated to account for nearly 70% of RA-related expenditures. Less than 7% of Medi-Cal RAs receive disease modifying antirheumatic drugs (DMARDs). More than 75% of Medi-Cal RAs received aspirin or NSAIDs. These relieve pain and inflammation, but have not been demonstrated to halt the process of joint destruction.

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