“Rheumatoid arthritis, in addition to generating a considerable physical and emotional burden on the lives of about 400,000 Italians, is linked to a significant economic impact on the direct and indirect costs of the disease. Achieving the goal of clinical remission, that is, having chronic disease under control, can lead to a significant reduction in costs for hospitalizations, specialist or outpatient visits, medical examinations, surgery, physiotherapy or orthopedic devices and fewer days lost in the workplace due to the disease. In other words, remission means guaranteeing the patient a better quality of life ”. Thus Silvia Tonolo, president of Anmar – National Association of Rheumatic Patients, comments on the results of a study published in ‘Advances in Therapy’, which highlight how achieving clinical remission in rheumatoid arthritis involves economic benefits, with savings of up to 75% of indirect costs. if rheumatoid arthritis is kept under control.
“For a patient living with rheumatoid arthritis, but in general with a rheumatic disease – explains Tonolo – means feeling a burden for society from a psychological, work and relational point of view. If he has not been taken care of by the rheumatologist in collaboration with the general practitioner to guarantee him a good quality of life, he will need to have a person to help him and will be forced to leave his job. We are talking about patients in full working age, at the beginning of professional activity or studies. Here, how can they face their future having a chronic and disabling disease? “.
Tonolo herself gives the answer: “A rheumatological pathology must be seen in all its aspects, not only the pharmacological one – says the president of Anmar -. I insist on being taken care of by specialists because empathizing with the doctor helps the patient’s journey. If the disease is well managed and kept under control, it allows the patient to reach the goal of remission, therefore to open a window on a black tunnel. But unfortunately many patients until recently did not know what remission was which, it is clear, does not mean healing but managing the disease well with a rheumatologist, general practitioner, the latter important during the pandemic despite not knowing rheumatological pathologies “.
From the point of view of direct costs, the achievement of clinical remission of rheumatoid arthritis, for Tonolo means that if “the patient does not need to keep the therapy forever but to follow it over time and perhaps suspend it – Tonolo emphasizes – If the patient takes a certain drug specially designed for him based on his medical history and comorbidities, returns to work. Therefore, from the point of view of direct costs, the patient goes less to the rheumatologist, maintains contact with the specialist if he needs to renew the treatment plan or to show him the tests every 3-6 months. There are no longer the costs for hospitalizations “.
“Let’s not forget – he continues – that rheumatological patients can have comorbidities over time, so they must always be monitored even when they are in remission because sometimes the patient says to follow the therapy even when he is well but in reality he tends to abandon it. not doing because remission does not mean suspending the treatment but it means managing the pathology well with drug therapy and the support of the rheumatologist. Furthermore, from the point of view of indirect costs – Tonolo emphasizes – we will no longer have sick leave, lost work days and the patient will take his therapy without having to combine it with other drugs for pain and acute management “.
In Italy, Anmar estimates, people with rheumatoid arthritis are about 350-400 thousand. “But many patients – he maintains – over time we have lost them due to the lack of early diagnosis, on which Anmar has been fighting since 1985. Certainly the two years of Covid have weighed, we have found less contact with the rheumatologist and the fact that the doctors of general practitioners do not have a clear idea of what the management of a patient with rheumatoid arthritis entails does not help. Yet, we are speaking not of a simple disease but of a real “obstacle course” for those who suffer from it “. For this “it is necessary to have national guidelines on rheumatological pathologies, among the Regions there is still no sharing of objectives in taking care of the patient. The motion brought forward with the Italian Society of Rheumatology, approved a few weeks ago, highlights what we have done together over the years for rheumatological patients, not only those with rheumatoid arthritis which is the best known rheumatological disease. We must not forget – he concludes – even those forced to live with psoriatic arthritis, with ankylosing spondylitis or with rare rheumatological diseases “.
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