Abstract
Healthcare expenditures in the United States are growing at an alarming level with the Centers for Medicare and Medicaid Services (CMS) projecting that they will reach $5.7 trillion per year by 2026. Inflammatory diseases and related syndromes are growing in prevalence among Western societies. This growing population that affects close to 60 million people in the U.S. places a significant burden on the healthcare system. Characterized by relatively slow development, these diseases and syndromes prove challenging to diagnose, leading to delayed treatment against the backdrop of inevitable disability progression. Patients require healthcare attention but are initially hidden from clinician’s view by the seemingly generalized, non-specific symptoms. It is imperative to identify and manage these underlying conditions to slow disease progression and reduce the likelihood that costly comorbidities will develop. Enhanced diagnostic criteria coupled with additional technological innovation to identify inflammatory conditions earlier is necessary and in the best interest of all healthcare stakeholders. The current total cost to the U.S. healthcare system is at least $90B dollars annually. Through unique analysis of financial cost drivers, this review identifies opportunities to improve clinical outcomes and help control these disease-related costs by 20% or more.
Highlights
Mounting an effective immune response allows mankind to fight off infection and perpetuate survival of the species
For the inflammatory diseases and related conditions that we examined, the cost-savings potential across all of these diseases collectively is estimated to be greater than 20%
multiple sclerosis (MS) patients are known to develop irritable bowel syndrome (IBS) in 10% of cases and up to 20% of patients with rheumatoid arthritis (RA) have been shown to fulfill diagnostic criteria for fibromyalgia syndrome (FMS) [2,44,86,87,88,89,90]. Management of these conditions accounts for less direct costs when compared to inflammatory diseases, but higher prevalence among these syndromes produces a cost burden that is larger than most inflammatory disorders [20,91]
Summary
Mounting an effective immune response allows mankind to fight off infection and perpetuate survival of the species. The similarities in manifestation, that are difficult to discern in the early stages of an inflammatory process when physical damage due to inflammation is minimal, often present a challenge to clinicians They are forced to decipher the cause of non-specific signs and symptoms using laboratory tests or imaging studies that are often inconclusive. This diagnostic methodology presents a difficult situation for both the patient and physician, as the diagnosis rests predominantly on clinical grounds with little to no conclusive evidence from standard laboratory tests or imaging studies [8] This tactic can result in a lengthy trial and error process, all the while the patient suffers unabated tissue damage. These four diseases affect over four million people in the U.S and cost the healthcare system an aggregated total of over $35B per year in direct costs alone, adjusted to 2018 inflated dollars
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