A Revised Estimate of the Burden of Illness of Gout

Abstract

BackgroundGout is a chronic, inflammatory arthritis characterized by painful and debilitating acute/episodic flares. Until recently, gout has been regarded as a minor medical problem, in part because the associated economic burden has not been appreciated. Previous literature on this subject focused on the costs associated with acute episodes of gout rather than on the long-term medical and economic implications of this chronic disorder.ObjectiveOur aim was to estimate the current impact of gout in the United States with respect to disability and economic costs.MethodsThe following data sources were used: published data on the incremental economic burden of gout; statistics from the US Census Bureau and the US Bureau of Labor Statistics; and recent epidemiological and clinical literature concerning the course, treatment, and outcomes of the disease. Disability is expressed as days of lost productivity. Charges for gout-related treatments were used as direct cost inputs.ResultsGout affects an estimated 8 million Americans, among whom those working have an average of almost 5 more absence days annually than workers without gout. On average, the incremental annual cost of care for a gout patient is estimated at >$3000 compared with a nongouty individual. Even though comorbidities common in gout patients account for a portion of this increased economic burden, the total annual cost attributable to gout patients in the United States is likely in the tens of billions of dollars and comparable to those of other major chronic disorders, such as migraine and Parkinson’s disease.ConclusionsThe economic burden of gout is most readily assessable in patients whose acute arthritic flares result in emergency department visits, bedridden days, and episodic loss of productivity. Chronic progression of the disease can also result in long-term impairment of function and health-related quality of life, but the contribution of chronic gout to the economic burden is more difficult to quantitate because gout is frequently associated with serious cardiovascular, metabolic, and renal comorbidities. Recent demonstration that successful gout management can reverse functional deficits in many chronic gout patients, however, supports the views that chronic gout contributes substantially to the medical and thus economic costs of these patients and that early and aggressive efforts to improve gout outcomes are likely to reduce the associated economic burden.

Prevalence of Gout in the Adult Population of France

“…Gout significantly reduces quality of life (5) and increases the use of health care facilities (6)(7)(8) and absenteeism from work (8). Gout is also an important independent risk factor of cardiovascular morbidity and mortality (9).…”

Prevalence and associations of gout and hyperuricaemia: results from an Australian population‐based study

“…4,5 In keeping with such disease burden, gout and hyperuricaemia pose a significant socio-economic loss; in the United states minimal estimates for annual costs exceed 6 million US dollars. 6 The prevalence of gout and hyperuricaemia varies depending on population and disease definition.…”

Patients with Gout Treated with Conventional Urate-lowering Therapy: Association with Disease Control, Health-related Quality of Life, and Work Productivity

“…In addition to causing pain, disability, and diminished quality of life, poorly controlled gout is associated with significantly higher healthcare costs and losses in productivity 6,7,8,9 . Recently, annual medical care costs for gout in the United States were conservatively estimated to exceed $6 billion in direct and indirect costs based on then-available prevalence data 1 .…”