The Financial Impact of Axial Spondyloarthritis

Reviewed by: HU Medical Review Board | Last reviewed: May 2020 | Last updated: July 2020

Living with a chronic, progressive condition can not only take a toll on your physical and mental health, but have very real effects on other areas of your life, including financially. If a chronic condition affects you physically, it can then impact your ability to work at the level you used to work at, or even affect your ability to work at all – which then impacts your financial status. Indirect costs can also include lost work hours of caregivers in your family and lost overall economic productivity of you and your caregiver.1 Frequent appointments and co-pays and medical bills can also contribute to financial demands of a chronic condition.

Employment and AxSpA

The physical limitations that may occur with AxSpA spectrum conditions can impact employment, especially if you have a job that involves physical activity. In one study of men living with AxSpA spectrum conditions, 45 percent switched to a job that was less physically demanding, and nearly a quarter (24 percent) retired early, at a mean age of 36, because of the AxSpA spectrum condition.2 Retiring that early also impacts future earnings and lost years of full economic productivity. The impact of this cannot be overstated, and can have significant effects on a family.

Symptom and disease activity also factors into AxSpA spectrum conditions and employment. The more disease activity and advanced the AxSpA, the higher the likelihood of not being able to work.3 Those with ankylosing spondylitis (AS), or r-AxSpA, are more likely to not be able to work because of their symptoms than those with nr-AxSpA.3 Especially if you “look normal,” people may not be able to understand your challenges in working. An “invisible” illness presents multiple challenges, and this is one of them.

If you’re experiencing difficulties at work, if possible, talk with your supervisor about your condition and ways to modify your workday. If you sit at a desk, take breaks to walk around the office and get up, practice good posture techniques, and find things that help alleviate your symptoms. Ask your health care provider about things you can do specific to the difficulties you’re facing.

Medical costs, health insurance, and AxSpA spectrum conditions

Getting a diagnosis of an AxSpA spectrum condition can take some time. In that time, a person may see their primary care doctor and several specialists, as well as have blood tests and imaging tests. All of this costs money, and health insurance may not always cover it in full, resulting in costs to the individual. Especially for those with nr-AxSpA, if it is not officially diagnosed and doctors are prescribing medications off-label for symptoms, there may be concerns about whether insurance will cover the cost of the treatments.

Treatment of AxSpA spectrum conditions can involve physical therapy and medications, and insurance may not cover this in full – and constant costs of treatment can add up, especially if you are not working or not working as much as you used to. If you’re seeing providers out-of-network, it may be beneficial to see if there is someone in-network you can see, as this will typically reduce costs. If the cost of certain medications is proving to be an obstacle, talk with your doctor about whether there is a generic version, or if it would be possible to switch to another medication. Sometimes there are vouchers or coupons that may be available, as well. Talk with your doctor about the economic realities of your health care treatment; they may be able to help reduce costs for you in certain areas.

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