Rheumatoid Arthritis Work Disability

Medication costs can be a limiting factor in patients with chronic illness being able to stick with treatment plans, and new research shows this may be particularly true for those who have lupus.

Patients with systemic lupus erythematosus (SLE) were twice as likely as people from the general population to report cost-related prescription nonadherence, reported an August 2020 study published in the journal Arthritis Care & Research. In particular, nearly 22 percent of lupus patients reported nonadherence compared to just 10 percent of the general population.

The researchers gathered this information by conducting interviews with participants from the Michigan Lupus Epidemiology & Surveillance (MILES) Cohort, which includes lupus patients and control subjects from southeastern Michigan.

Cost-related prescription nonadherence was determined by participants reporting at least one of the following in the previous year to save money:

  • Skipping doses
  • Taking less medicine
  • Delaying the filling of a prescription

There were disparities with income, race, and health insurance status, but the researchers’ main findings persisted even after adjusting for these and other variables.

What’s particularly striking: Less than one in four patients had asked their doctors for lower-cost medications.

In particular, only 23.8 percent of lupus patients and 15.6 percent of controls from the general population reported asking their physician for lower-cost alternatives.

Because of this, it’s important that doctors be aware of medication costs to individual patients when trying to ensure adherence, planning treatment changes, and prescribing medications. And if you’re a patient taking a medication that you are having trouble affording, don’t be afraid to let your doctor know. They may be able to prescribe a less-costly alternative or help you obtain financial assistance, say, from a medication support program.

“Consideration of medication costs in patient decision-making could provide a meaningful avenue for improving access and adherence to medications,” note the researchers.

Lupus is an autoimmune disease that occurs when the body’s immune system attacks its own organs and tissues, per the Mayo Clinic. This causes inflammation that may affect many parts of the body, including the joints, kidneys, skin, blood cells, brain, lungs, and heart.

There is no cure for lupus, which is why treatment is so important for controlling symptoms and preventing serious organ damage.

However, the costs do add up for lupus patients: Average annual direct medical costs for lupus patients can range from $8,900 for those with mild disease to $83,000 for those with moderate or severe disease, with annual pharmacy costs ranging between $1,572 and $13,138, found a June 2017 systematic review in the journal Annals of the Rheumatic Diseases. Some of the authors of this 2017 study noted that they were employees of the pharmaceutical company AstraZeneca in a disclosure of interest.

If you’re a patient with lupus, talk to your doctor about all treatment options, especially if cost is limiting your ability to take your medication.

Want to Make Medication More Affordable?

Get involved in patient advocacy. The 50-State Network is the grassroots advocacy arm of CreakyJoints and the Global Healthy Living Foundation, comprised of patients with chronic illness who are trained as health care activists to proactively connect with local, state, and federal health policy stakeholders to share their perspective and influence change. If you want to effect change and make health care more affordable and accessible to patients with chronic illness, learn more here.

Hammond E, et al. Health care utilization and costs of systemic lupus erythematosus (SLE) in the united states: systematic review. Annals of the Rheumatic Diseases. June 2017. doi: http://dx.doi.org/10.1136/annrheumdis-2017-eular.5224.

Lupus. Mayo Clinic. October 25, 2017. https://www.mayoclinic.org/diseases-conditions/lupus/symptoms-causes/syc-20365789.

Minhas D, et al. Access and cost‐related non‐adherence to prescription medications among lupus cases and controls: the Michigan Lupus Epidemiology & Surveillance (MILES) Program. Arthritis Care & Research. August 2, 2020. doi: https://doi.org/10.1002/acr.24397.