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A new study led by researchers at the McGill University Health Centre (MUHC) reveals high medical costs for children suffering from juvenile idiopathic arthritis (JIA). The study, to be published in the February issue of the journal Arthritis and Rheumatism, shows that the average annual medical cost for a child with JIA is $1,686 higher than for a child without JIA. This expense is mostly borne by Canada's health care system, though some of the costs are also absorbed by private insurance. In addition, however, families with a child suffering from JIA experience average annual salary losses of $1,241.

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children, affecting approximately 1 in 1,000 children in Canada./p>

"Many of the symptoms of JIA are much like those of adult inflammatory arthritis, with children suffering joint pain, stiffness and swelling," says the study's principal author, Dr. Sasha Bernatsky, a researcher in the Division of Clinical Epidemiology at the MUHC and an assistant professor in the Faculty of Medicine at Ï㽶ÊÓƵ.

"Unlike adult arthritis, however, very little is known about the economic impact of the disease," she said. "Our study indicates that JIA is one of the most costly chronic medical conditions in childhood. In addition to monetary costs, however, JIA creates significant social costs for the child and for the family."

The new study is the first to assess the substantial financial burden of caring for children with JIA, with the aim of ensuring optimal medical care for patients. The researchers distributed questionnaires about medications and health services to families of 155 children with JIA and 181 control families from two hospitals located in Montreal and Vancouver, Canada.

"At $1,686, the average annual medical costs associated with JIA were significantly higher than for the control group," says Dr. Bernatsky. "This is in part a result of the higher medication costs associated with JIA, as well as the higher cost of specialists, health care professionals and diagnostic tests."

Researchers also asked parents about the amount of time lost from work to care for their children. Annual parental salary losses were over three times those of the control population.

The study did not quantify the long-term medical and social costs if arthritis is inadequately treated during childhood. "Ongoing active inflammation and the consequent joint damage may have a significant social impact on an individual," says Dr. Bernatsky. "For example, compared to children without arthritis, JIA patients miss more days of school; on average, between one and two weeks per year. Almost twice as many children with JIA missed at least one school day per year, as compared to children without JIA. More effective interventions, even if associated with higher initial health care costs, may well have significant long-term cost savings.

"Insight into factors which influence health care costs can help clinicians and decision makers in resource allocation, which is increasingly important in this time of economic constraints on health care systems," noted Dr. Bernatsky. "We hope our results will help motivate policy makers to ensure good access of patients to optimal medical care."

Article: Arthritis & Rheumatism (February 2007).
Sasha Bernatsky, Ciaran Duffy, Peter Malleson, Debbie Ehrmann, Feldman, Yvan St. Pierre, Ann E. Clarke.

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