The current healthcare environment in the U.S has seen a shift in understanding that autoimmune disease is a costly disease category, but how significant is it? Autoimmune disease comes in as the third therapeutic class by non-discounted spending at $54.1 billion, with antidiabetics as #1 and oncologics as #2. A growing number of people are treated with new specialty medicines that are proven effective in more indications. The number of autoimmune patients that receive drug treatments grew by 20% in 2018 and there has been a 63% increase in patients treated for autoimmune diseases from 2013 to 2018 and treatment has added $3.9 billion in cost as treatment options become available for patients with a range of conditions.
The Impact of Autoimmune Disease on Employee Productivity
Autoimmune disease is often invisible - you do not need to look sick to be sick. Apart from the financial costs associated with hospital utilizations, specialist visits, and medications, there are also significant impacts on productivity in the workplace. The chronic nature of autoimmune conditions causes patients to often experience symptoms such as pain, fatigue and brain fog frequently, severely impacting their productivity at work and reduces their quality of life. Many cannot keep working as a result of the disease and those employed struggle to hold their job and suffer in silence.
While it is difficult to estimate costs related to absenteeism and presenteeism, some numbers for the top diseases are:
- 15%, 36%, 51%, and 63% of patients stopped working after 5, 10, 15, and 20 years of disease duration
- Absenteeism accounts for 2.3 sick days each month, compared to the general US population figure for 2016 from the Bureau of Labor Statistics of 0.3 sick days each month
- 80% of patients are working at 2 years, and 68% are working at 5 years
- Impact of RA-related morning sickness:
- Affected work performance: 47%
- Late arrival at work: 33%
- Required sick leave in past month: 15%
- A study found a 14% rate of absenteeism among employees, presenteeism rate was close to 40%, and productivity loss approached 50% 
- About 35% of patients felt that the disease limited their work productivity, and about 14% reported that it led them to work fewer hours than they wanted to
- IBD: A US survey showed that IBD patients incur an additional 4.8 days off work
 “Medicine Use and Spending in the U.S. - A Review of 2018 and Outlook to 2023.” IQVIA Institute, May 2019.
 Scofield L, Reinlib L, Alarcón GS, et al. Employment and disability issues in systemic lupus erthyematosis: a review. Arthritis Rheum. 2008;59(10):1475-9. doi: 10.1002/art.24113.
 “Understanding the many costs of lupus.” AstraZeneca, 16 Jun 2017, https://www.astrazeneca.com/media-centre/articles/2017/understanding-the-many-costs-of-lupus.html#.
 Davis JM, Matteson EL. My Treatment Approach to Rheumatoid Arthritis. Mayo Clinic Proceedings. 2012;87(7):659-673.
 Mattila K, Buttgereit F, Tuominen R. Impact of morning stiffness on working behaviour and performance in people with rheumatoid arthritis. Rheumatol Int. 2014;34:1751-1758.
 “Psoriatic Arthritis in the Workplace.” Arthritis Foundation.
 “Working with psoriasis and psoriatic arthritis.” National Psoriasis Foundation. 14 Dec 21015.
 Keunzig ME, Lee L, El-Matary W, et al. The Impact of Inflammatory Bowel Disease in Canada 2018: Indirect Costs of IBD Care. Journal of the Canadian Association of Gastroenterology. 2018;2:S34-S41. https://doi.org/10.1093/jcag/gwy050