By Educators – Institute of Functional Medicine – ifm.org
While the direct economic cost of autoimmune diseases in the US is difficult to determine, the National Institute of Allergy and Infectious Diseases estimates that the annual cost to the healthcare system is more than $100 billion, not including the cost of uninsured individuals, which is estimated to be at least another $25 billion per year, according to the American Autoimmune Related Diseases Association.5
Autoimmune diseases have increased dramatically worldwide since 1939,1 encompassing more than 80 disorders.2 Collectively, autoimmune disorders are among the most prevalent diseases in the US; they are the third most common category of disease after cancer and cardiovascular disease, affecting approximately 5 to 8% of the US population, or 14.7 to 23.5 million people.3 Rheumatoid arthritis (RA), psoriasis, and inflammatory bowel disease are among the most common.4
There has been limited success in the development of approved medications for autoimmune diseases.5 The goal of contemporary treatment for RA is to halt or slow the progression of the disease before joint damage occurs.6 Treatment with disease-modifying antirheumatic drugs (DMARDs) and biologic DMARDs in the early stages of RA has made joint destruction less common, but not all patients respond to DMARDs—either the conventional or biologic variety.5
A 2012 report showed that the effectiveness of approved therapeutics in a broad group of autoimmune diseases was no more than 50%.5 Effectiveness was expected to be even lower in the case of biologic therapies, which do not achieve remission in greater than 20–30% of patients.5 Although biologics have proven to be an effective treatment for RA and other diseases, like psoriasis, they are recommended only for patients with insufficient response or intolerance to DMARDs because of their cost.6
Prescription treatments can also lead to devastating long-term side effects; for example, DMARDs have been significantly associated with dementia in RA patients.7 Compared with the general population, patients with RA have twice the mortality rate, with median life expectancy reduced by seven and three years in men and women, respectively.4 Other comorbidities of the disease include osteoporosis, infection, subcutaneous nodules, Sjögren’s syndrome, lung disorders, and lymphoma.4
If left untreated or poorly controlled, RA limits the ability of patients to function well in vocational or domestic settings.4 Research has shown that up to half of such patients leave the workforce less than 10 years after disease onset; up to 90% stopped working prior to age 65. The total cost of RA in the US in 2005 was estimated at $39 billion. About half of the total was attributed to intangible costs—with $10 billion attributed to diminished quality of life and $10 billion to premature mortality.4
Mindfulness meditation, a cognitive practice premised on sustaining nonjudgmental awareness of arising sensory events, also reliably attenuates pain in autoimmune patients.9 Mounting evidence also supports the effectiveness of acupuncture to treat chronic pain conditions (although not all chronic pain cases studied in this report were autoimmune in nature).10
While prescription medications remain at the forefront in the battle against autoimmune disease, researchers are identifying other treatment modalities (including exercise and meditation) to help improve patients’ quality of life. Functional Medicine offers an alternative to symptom suppression—by addressing the underlying mechanisms that cause autoimmunity, we can prevent, and in some cases reverse autoimmune diseases.