Tuesday, September 27, 2016
Rheumatoid Arthritis-Impacting 10% of the U.S. Population, Treatment, and Research
Treatment and Research for Rheumatoid Arthritis and Other Autoimmune Diseases
Rheumatoid Arthritis (RA), the first time I heard of this disease as a college sophomore, I was amazed it affected young people. The treatment used to be loads of steroids, which have plenty of side-affects including weight gain. My little-league-pitching nephew, Sebastian was struck with this dreaded youth flaying arthritis when he was twelve years old. I went to one of his games and yelled, “Swing batter” or “Knock the cover off”, not PC at all, but I am so glad I did it. His diagnosis was a slow process and needless to say, it ended his pitching career. When Sebastian came to visit me for one of our camping expeditions, I took him to a Mariners game (at his request). After sitting through all of the innings, he could barely get up and drag himself the few blocks to the car. It was as if his limbs were numb. This disease affects 10% of our nation, 1 in every 100 people.
21st Century Treatments
Flash forward to the advent of two important innovations in the 21st century, first the introduction of the arthritis treatment, etanercept, was approved for treatment of RA in 1998, and became ubiquitous for treatment a few years later. When Enbrel was launched by Amgen, the price of the drug was $1,500 a month per patient or $18,000 a year, in 2008. The current price of this medication is about $40,000 per patient per year in the U.S. In 2015, Canadians paid about $20,000 per patient per year for the same medication, no wonder they are so pleasant up north.
How Do People Pay for this Drug?
One giant leap forward for humanity in 2010, when the Patient Protection and Affordable Care Act mandated that insurance companies could no longer discriminate on the basis of health. This law made it much easier for Sebastian and others like him to gain access to affordable health insurance and thus, treatment. With the medicine he has been able to thrive, working for the same employer for five years, working out at a gym, and welcoming the birth of his second child. It is doubtful this would have been possible without access to health care. Employers frown on employees who are tired or move a bit stiffer than the others, even if they are in their twenties and this is what life was like without his medication.
As of this year, there are three biologic drugs approved by the Federal Drug Administration, all of which will compete with Enbrel, so that should soften the price somewhat. Of course the way our nation pays for drugs without negotiating effectively with their largest customer (the government) is the antithesis of good stewardship.
New Horizons for researching a cure for Rheumatoid Arthritis
The Benaroya Institute, long noted for its research to cure type 1 diabetes and global leader of the Type 1 Diabetes Trial Net study to identify those at risk of diabetes, which is funded by the National Institutes of Health, is also studying the cellular behavior of people with RA compared to the non-RA population. This approach is to detect those vulnerable to this debilitating disease earlier and pre-treat the condition before full blown symptoms occur. The Benaroya Research Institute has also been awarded an 8 million-dollar grant from the National Institute of Allergies and Infectious Diseases to study the lung epithelium cells, which provide the main response to allergens.  The foundation’s research shows that multiple autoimmune diseases are often more likely to occur in family populations with an existing autoimmune disease, such as RA. If you are interested in learning more about current research on cellular behavior to identify, pre-treat, and eventually cure autoimmune diseases like Rheumatoid Arthritis or Type 1 Diabetes, join the scientists at the foundation’s annual outreach luncheon to learn more. This year’s event will be held at the Fairmont Hotel in Seattle on October 28, 2016. To participate in the event, find more information at this link:
This article was written by Roberta E. Winter, using the trademark healthpolicymaven, and may be shared virally. Winter is the author of https://www.amazon.com/Unraveling-U-S-Health-Care-Personal/dp/1442222972 as well as 97 articles on healthcare systems and resourcing better health care.