Top 10 Most Expensive Diseases: How to Save
Medically reviewed by L. Anderson, PharmD Last updated on Jan 24, 2019.
Low Back Pain and Neck Pain
Almost everyone experiences some form of musculoskeletal pain during their lifetime, and our necks and backs are certainly at the top of the list. Personal healthcare spending for this group comes in at a whooping $88 billion annually in the US, according to a Journal of American Medical Association (JAMA) report.
Back pain usually originates in the spine and the muscles that support it. Neck pain can originate from poor posture and osteoarthritis, too. You could get back pain or neck pain by slouching at a computer all day, or straining your back or neck in exercise or sports activity.
To prevent problems it’s important to stretch before exercise, watch your posture, lose weight if needed, work ergonomically at your desk, and use caution when lifting heavy items.
While therse tips can help, sometimes pain relief is needed.
- Pain medications like acetaminophen (Tylenol), NSAIDs like ibuprofen (Motrin, Advil) or naproxen (Aleve) are available over-the-counter (OTC) and most people can afford them.
- Be sure to check side effects and warnings found on the OTC Drug Facts Label before you use any of these drugs.
- Ask your pharmacist if there is the possibility of any drug interactions with your prescription medicines, herbals, vitamins or other OTC agents you use.
High Blood Pressure: Often Undetected
With 1 in every 3 American adults diagnosed with high blood pressure it’s no wonder the cost for treating patients with this condition totals over $83 billion yearly, as reported in JAMA.
There is good news: many of the most popular blood pressure medications are available generically and are typically very affordable, examples include:
- Angiotensin-Converting Enzyme inhibitors (ACE inhibitors)
- Angiotensin Receptor Blockers (ARBs)
- Calcium Channel Blockers
Blood pressure is the force of blood against your artery walls as it circulates through your body. It can greatly increase your risk of certain health problems like heart disease and stroke if it remains untreated.
High blood pressure often goes undetected because it has no warning signs or symptoms so it is important to get your blood pressure checked regularly. Adults ages 30 and older without high blood pressure should have their blood pressure checked yearly, but with heart risk factors, older age, borderline readings, or history of high blood pressure more frequent readings may be needed.
Hepatitis C Virus: Advances Are Significant
Hepatitis C virus (HCV) is not only costly, it's frequently a hot news item.
With health officials urging baby-boomers to get tested for HCV, and new all-oral regimens offering a cure in a matter of a few months, HCV has undergone major treatment advances.
As with any big breakthrough, treatment of HCV does not come cheap.
- Uproar started over high-priced antiviral treatments like Sovaldi (sofosbuvir) and Harvoni (ledipasvir and sofosbuvir). For these agents, total treatment costs can hover in the $45,000 to $50,000 range for 12 weeks of treatment.
- Newer agents like Epclusa (sofosbuvir and velpatasvir) that can be used in a 6 HCV genotypes run close to $75,000 for 12 weeks of treatment, and one of the latest HCV approvals, Mavyret (glecaprevir and pibrentasvir), also for all 6 genotypes, can set you back about $43,000 for 12 weeks.
- Prices are always subject to vary, so check with your insurance or specialty pharmacy to determine the best way to pay for these drugs.
- Cost savings for this condition are usually through insurance or possibly with a manufacturer's patient assistance program. Ask your doctor or specialty pharmacy about these options.
Cost effectiveness of a cure may offset a continued lifetime of difficult-to-control disease, as reported in JAMA Internal Medicine. Costs for HCV are expected to peak in 2024 at over $9.1 billion. Whether insurance will cover early HCV disease with the newer oral agents (in early vs. late liver fibrosis) has some questioning the timeline to fully eradicate HCV, suggesting it could be a decade or longer.
Diabetes: A Common and Costly Condition
In all forms of diabetes there is too much sugar in the blood which can lead to serious health complications over time including heart and kidney disease, eye disorders, nerve damage and even limb amputations. Hospital care, anti-diabetic medications and supplies such a insulin and needles, treatments for complications and regular doctor visits all contribute to the burden of cost.
Diabetes affects over 9% of Americans with medical expenses totaling over $100 billion per year as noted in the JAMA report. Plus, the CDC estimates that 84 million Americans (roughly 1 out of 3) have prediabetes, a precursor to full-blown diabetes. The numbers are frankly staggering: more than 100 million U.S. adults are now living with diabetes or prediabetes.
Lantus (insulin glargine), a long-acting type of insulin, can run close to $300 for a 5 pack of insulin pens. Insulins are notiously expensive for patients with diabetes, and no generic options are available. Luckily, metformin (brand name: Glucophage), one of the most commonly used oral diabetes medications is available generically and may even be free at some pharmacies. The average cash price per month runs about $6 to $12 dollars.
- Healthy lifestyle choices such as eating a well-balanced diet, exercising regularly and managing your weight may lower your chance of getting type 2 diabetes.
- If you do develop diabetes, it's imperative you follow your doctors orders, take your medications as directed, and continue to follow a healthy and active lifestyle to control your conditon -- and your healthcare costs.
Learn More: Treatment of Diabetes
Costs of Osteoarthritis & Joint Problems
By the year 2040, an estimated 78.4 million adults aged 18 years and older (1 in 4 adults) will have doctor-diagnosed arthritis. The age of the US elderly population is expanding and so will the diagnosis of arthritis.
Osteoarthritis (OA) is the most common form of arthritis and affects more than 30 million adults in the U.S.
- OA is caused from the gradual wear and tear of the cartilage between the bone causing pain, stiffness and inflammation.
- This chronic condition is more common as we age and often results in a knee or hip replacement.
- Medications, physical therapy, and hospitalization for surgery all contribute to the cost.
- Maintaining a healthy body weight and non-weight bearing exercise like swimming or cycling may help to keep the joints mobile without pain.
The back, neck, knees, hips, and hands are common targets of OA. It is no surprise then that annual costs for OA exceeds $47 billion annually, and it was listed in the top 20 of health care spending by condition according to JAMA. OA is also among the most expensive conditions to treat when costly joint replacement surgery is required.
Chronic Obstructive Pulmonary Disease (COPD) and Asthma
The most common medications in this group are still pricey, but costs are coming down.
- GSK's Ventoin HFA inhaler is now available as an authorized generic at roughly $30 cash price. Proair HFA and Proventil still don't have generics. All of these agents were reformulated in 2008 to remove hydrofluorocarbons.
- An inhaled corticosteroid like Qvar (beclomethasone) runs between $200 and $300, also with no generic options. If you are willing to use a nebulizer, much more affordable inhaler solutions are available for some agents. Ask your pharmacist for details.
- Advair (fluticasone and salmeterol), used commonly for COPD, is not yet affordable as a generic, either, and can set you back $400 per inhaler, or more.
Roughly 11 million American adults are living with some form of COPD, and 25 million have asthma.
- Smoking tobacco is the main cause of COPD but air pollutants and genetics are also culprits.
- There is no cure for COPD and costs incurred are from medications, frequent doctor visits, and in severe cases, hospitalization.
- For current smokers, smoking cessation is essential for preventing and managing COPD.
- To control asthma attacks, avoid triggers, like tobacco smoke, dust mites, and pollution.
- Take anti-inflammatory inhalers, fast-acting inhalers, or other medications as instructed.
Mental & Behavioral Health Disorders
Mental health disorders encompass many different conditions. Annual U.S. medical cost for depression is roughly $71 billion, according to the JAMA report.
About 15 million live with major depressive disease. Anxiety disorders result in a cost of over $29 billion, and attention-deficit hyperactivity disorder (ADHD) tallies $23 billion per year. Luckily, many of the most commonly used antidepressants, like the selective serotonin reuptake inhibitors (SSRIs) are now available generically and are very affrodable.
Medicines are expensive and doctor visits are frequent. But noncompliance and lack of follow up with doctors can be high in this group of patients, too, adding to the total healthcare dollar.
Cancer: Advances Lead to Increased Survival
Every year, cancer ends the lives of more than 500,000 Americans. In fact, 1 in every 4 deaths in the US is due to a cancer-related illness.
According to a JAMA article, the top 4 cancer costs include:
- colorectal cancers,
- breast cancer
- other neoplasms
- non-melanoma skin cancers such as basal or squamous cell carcinoma.
Costs exceed $50 billion just for these top 4 cancers. Based on the continued aging and growth of the U.S. population, costs of new immunotherapy agents, and new diagnostic tools, these costs are predicted to increase.
It’s not all bad news though -- the cancer death rate has significantly decreased over the last decade. Factors driving this drop include less tobacco use, sun protection, eating well, regular exercise, earlier detection and better treatments.
Falls, Injuries, and Broken Bones
Falls are costly and serious events. In fact, 1 out of every 5 falls causes a serious injury such as a broken bone or a head injury, according to the CDC.
- Each year, trauma accounts for 37 million emergency department visits and 2.6 million hospital admissions so it's no surprise that annual costs due to injuries from falls comes in $76 billion.
- Falls in the elderly are a top concern due to morbidity and mortality linked with hip fractures.
- Each year at least 300,000 older people are hospitalized for hip fractures.
- Research shows that women have a 5-fold increase of death within one year after sustaining a hip fracture, and men an 8-fold increase.
Heart Disease: The #1 Killer
Heart disease is the number one cause of death in the United States, killing over 370,000 people a year.
As reported by the American Heart Association, costs of cardiovascular disease and stroke total more than $316.6 billion, including health expenditures and lost productivity. After diabetes, ischemic heart disease (coronary artery disease) ranks as the nation’s 2nd most costly medical condition with a grand expenditure of just over $88 billion per year.
Hospitalization, surgery, diagnostic tests, monitoring, specialist doctor visits and medicines all contribute to the price.
- To reduce your risk of heart disease, adjust your lifestyle by maintaining a normal weight, eating a healthy diet, not smoking, and getting regular exercise.
- Preventing and controlling high blood pressure and high cholesterol also play a significant role in heart health.
The good news is that many medications for heart disease can be affordable. Blood pressure medications, high cholesterol treatments, and drugs used for heart failure and coronary artery disease are generic and easy to afford. If you are having trouble with costs, talk to your doctor or pharmacist about ways to save.
Finished: Top 10 Most Expensive Diseases: How to Save
- Dieleman, JL; Baral, R; Birger, M; et al. US Spending on Personal Health Care and Public Health, 1996-2013. JAMA. 2016;316(24):2627-2646. Accessed 1/24/2019 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551483/
- Cisternas MG, Murphy L, Sacks JJ, et al. Aternative Methods for Defining Osteoarthritis and the Impact on Estimating Prevalence in a US Population-Based Survey. Arthritis Care Res (Hoboken). 2016;68(5):574–580. Accessed 1/24/2019 at https://www.ncbi.nlm.nih.gov/pubmed/26315529
- Heart Disease, Stroke and Research Statistics At-a-Glance. American Heart Association. Accessed 1/24/2019 at https://www.heart.org/idc/groups/ahamah-public/@wcm/@sop/@smd/documents/downloadable/ucm_480086.pdf
- The Centers for Disease Control and Prevention (CDC). Data and Statistics. Accessed 1/22/2017 at https://gis.cdc.gov/grasp/diabetes/DiabetesAtlas.html
- Comparison of Hepatitis C Treatment Costs. IMS Institute for Healthcare Informatics. Sept. 2016. Accessed January 22, 2017
- Chronic Disease Overview. Centers for Disease Control and Prevention (CDC). Accessed January 22, 2017.
- American Diabetes Assoc. Statistics About Diabetes. Accessed 1/24/2019 at http://www.diabetes.org/diabetes-basics/statistics/
- The Centers for Disease Control and Prevention (CDC). Statistics for Different Kinds of Cancer. Accessed 1/24/2019 at https://www.cdc.gov/cancer/dcpc/data/types.htm
- Important Facts about Falls. The Centers for Disease Control and Prevention (CDC). Accessed January 21, 2018 at https://www.cdc.gov/homeandrecreationalsafety/Falls/adultfalls.html
- National Cancer Institute at the National Institutes of Health. Cancer costs projected to reach at least $158 billion in 2020. https://www.nih.gov/news-events/news-releases/cancer-costs-projected-reach-least-158-billion-2020. Accessed 1/22/2019
- US.National Library of Medicine, NIH. Incidence of economic burden of injuries in the United States. Accessed 1/22/2017 at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2652974/
- Chahal HS, et al. Cost-effectiveness of Early Treatment of Hepatitis C Virus Genotype 1 by Stage of Liver Fibrosis in a US Treatment-Naive Population. JAMA Intern Med. 2016 Jan;176(1):65-73. Accessed 1/24/2019 at http://www.ncbi.nlm.nih.gov/pubmed/26595724.
- U.S Department of Heath & Human Services. Agency for Healthcare and Quality. MEPS Topics: Health Care Costs/Expenditures. Accessed 1/24/2019 at http://meps.ahrq.gov/mepsweb/data_stats/MEPS_topics.jsp?topicid=5Z-1
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.