Arthritis is a common and chronic disease with over 200 conditions included in this category. It affects every tenth inhabitant of the world according to the World Health Organisation (Novosti Press Agency, 1990). Indeed, arthritis and rheumatism are the most frequent self-reported condition in Great Britain with a rate of 80 per 1000 females and 40 per 1000 in males (OPCS, 1989). The Arthritis and Rheumatism Council claim a total figure in the UK of about 20 million people with some form of arthritic disorder, with between six and eight million significantly affected. Yet, it receives little public or media attention, since it rarely causes death and is often considered solely a disease of the elderly. However, ‘arthritis is no respecter of age, sex, race, colour or creed’ (Dieppe, 1988) – although the prevalence does increase with age (see p i 7) – and is the major cause of disability in this country (OPCS, 1988).
This paper will show that the morbidity of arthritis results in substantial costs to society and to the individual. It is estimated that the cost of arthritis to the National Health Service (NHS) in 1989 was nearly £500 million. This figure includes hospital costs of £231 million and general practice costs of £45 million. In addition pharmaceutical services absorbed £219 million, nearly one tenth of the total cost of pharmaceutical services in 1989. Furthermore, the total cost to the NHS is set to rise as the number of very elderly (over 75 years old) increases, causing costs to increase by some 14 per cent by the year 2001. However, this figure does not take account of the personal and indirect costs such as loss of earnings; arthritis accounts for nearly 11 per cent of all working days lost. The Arthritis Foundation (1982) in the United States included such areas in its calculation of the total cost of arthritis and arrived at a figure of $13.5 billion in 1982, or about £12,000 million at 1990 prices1. If it is assumed that the population of the United Kingdom is about one-fifth of the USA and it is conservatively estimated that the cost to the UK is only a half of that in the USA per patient it can be estimated that the total cost of arthritis in 1990 in the UK was £1,200 million. Therefore ‘this expensive and chronic condition should be given far higher priority’ (Agnew, 1991).