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Vaccines for the 21st Century: A Tool for Decisionmaking
Table A21–1 Incidence Rate for Rheumatoid Arthritis
Incidence Rates (per 100,000)
form experienced by 15% of people with RA is associated with a health utility index (HUI) of .91 for 1 year. A moderate form of RA experienced by 65% of the patients was associated with lifelong disease at an HUI of .72. It was assumed that there was premature death by 3 years in these patients.
For 15% of RA patients who experience a progressive disease, it was assumed that the remainder of life was spent in an average HUI of .49. Life expectancy was shortened by 5 years in these patients. For 5% of patients, RA manifests with severe systemic manifestations and is associated with an HUI of .33. Life expectancy was assumed to be decreased by 7 years in these patients. See Table A21–2.
COST INCURRED BY DISEASE
Table A21–3 summarizes the health care costs incurred by RA. For the purposes of the calculations in this report, it was assumed that initial treatment for all RA patients includes 4 visits to a physician (half will seek the attention of a specialist), medication, and diagnostic evaluation. Patients with a limited, benign course seek no further treatment. Yearly health care costs for patients experiencing chronic, moderate disease were assumed to include semi-annual visits to a physician (50% to a specialist) and medication. It was assumed that on average, each year 10% of patients would require hospitalization and rehabilitation services. Annual care for patients with progressive, serious disease was assumed to include quarterly visits to a specialist, medication, and hospitalization and rehabilitation services for 25% of patients. Annual care for patients with severe systemic disease was assumed to be associated with bimonthly visits to a