The economic burden of gout on an employed population

Objective: To examine the economic burden of illness of gout in an employed population, quantifying the impact on employers annual health benefit costs for medical and prescription claims, sick leave, short- and long-term disability, and workers' compensation. Methods: Adjudicated claims data from 300000 employees from 2001 through 2004 were utilized. T-tests were used to compare demographic data and medical costs and services by Agency for Healthcare Research and Quality (AHRQ) diagnostic categories. Two-part models were used to determine average annual health benefit costs overall and medical costs by place of delivery. A risk stratification quintile analysis was also performed utilizing gout-specific medical and pharmaceutical costs. Results: There were 1171 employees with gout identified ( total n = 249038). All demographic variables between the two groups were statistically different ( p <= 0.05). The total annual cost for the employee with gout versus without gout was $6870 versus $3705, respectively, with significantly higher costs for medical claims, prescription claims, sick leave, short-term disability, and workers' compensation benefits. Costs were significantly higher by location of service for office, outpatient hospital or clinic, inpatient hospital, and laboratory. For the gout cohort, the top major diagnostic category in average cost was 'circulatory system' and in average services was 'endocrine, nutritional, metabolic, and immunologic systems'. Only 0.9% of employees with gout generated 20% of the total gout-specific medical and prescription costs. Conclusion: Gout inflicts a substantial burden of illness upon employers in terms of medical and prescription costs, as well as other work-related benefits.