If you have ankylosing spondylitis (AS), your biggest struggle is to somehow manage the disease, reduce pain, and continue with your daily activities. While you're struggling with those physical difficulties, you can also feel overwhelmed by the sudden arrival of large medical bills and doctor's fees. So without further ado, let's talk about the costs of this disease and how to manage them.
First of all, what is ankylosing spondylitis (AS)?
Simply put, ankylosing spondylitis is a type of arthritis. It mainly affects your spine. Over time, this disease can cause your vertebrae to fuse together. This can cause your spine to lose its flexibility and become hunched forward.
In addition to this, you may experience pain and discomfort in your ribs, hip joints, and shoulder joints. Sometimes, painful inflammation of the eyes may also occur.
The most important thing is that there is no cure for this disease yet . However, with the right medications and physical therapy, symptoms can be controlled and progression of the disease can be largely controlled. Surgery is only needed if there is severe damage to the joints, and that is very rare.
What are the costs of treatment?
During flare-ups of AS, your medical costs increase. These costs can be divided into several main categories.
1. Regular Office Visits
For this condition, you will most likely see a rheumatologist . They will usually examine you and discuss your treatment plan about every 3 months. However, during periods of increased pain and discomfort, you may need to see the doctor more often. As you know, each of these consultations costs money.
2. Physical Therapy Sessions
Physical therapy is a very important part of the AS treatment plan. A good physical therapist can help you reduce your pain, improve your strength and flexibility, and teach you exercises you can do at home.
However, these treatments also come at a cost. Since multiple sessions are usually required, they can add up over time. If you have health insurance, it's a good idea to check ahead of time to see if physical therapy is covered.
Types of drugs used for treatment and their cost
There are several types of medications used to treat AS. Your doctor will prescribe these based on the nature of your condition. There can be a big difference between these medications and their costs.
| Drug Type | Why use? | Examples |
|---|---|---|
| Painkillers (NSAIDs) | To control pain and inflammation in the early stages. These are relatively inexpensive. | Ibuprofen, Naproxen, Indomethacin |
| DMARDs (Disease-Modifying Antirheumatic Drugs) | To reduce joint swelling and pain when the disease is difficult to control with NSAIDs alone. | Sulfasalazine, Methotrexate |
| Biological drugs (Biologics) - TNF blockers - IL-17 inhibitors | Very powerful drugs used in severe cases of the disease that are difficult to control. They reduce pain, stiffness, and inflammation. These are very expensive. | Adalimumab (Humira), Etanercept (Enbrel), Infliximab (Remicade), Secukinumab (Cosentyx) |
| JAK Inhibitors | Another powerful class of drugs used for patients who do not respond to other biologics. These are also very expensive. | Tofacitinib (Xeljanz) |
As you can see, while the initial painkillers are not that expensive, the drugs that are given as the disease becomes more difficult to control, such as biologics and JAK inhibitors, can be very expensive . These come as injections or pills, and you can end up paying a lot of money per dose.
So, how do you manage these expenses?
This disease can be physically, mentally, and financially draining. But don't worry. You can reduce this burden by thinking about it in advance and taking action.
- Talk openly with your doctor: This is the most important and first step . Talk to your doctor about your fears and discomfort about the cost of treatment without hesitation. He or she will be able to advise you on alternative treatments that are suitable for you and less expensive.
- Understand the difference between the public and private sectors: One of the biggest advantages we have in Sri Lanka is the public hospital system. Ask your doctor if you can get some expensive medications through public hospitals. If you are getting these medications from the private sector, it is also a good idea to compare prices at different pharmacies.
- Check your insurance coverage: If you have private health insurance, check to see if it covers medical appointments, physical therapy treatments, and medications related to this condition, and to what extent.
- Look for support groups: There may be associations or support groups formed by people with such long-term illnesses. You can find information and emotional support from such places.
Take-Home Message
- Ankylosing spondylitis (AS) is a long-term condition that requires ongoing management.
- These costs include doctor visits, physical therapy, and especially very expensive medications like biologics.
- The most important thing is to talk openly and honestly with your specialist about your treatment plan and the associated costs.
- Avoid putting off treatment because of the cost. Instead, proactively plan to deal with the problem.
- Research the services available at government hospitals and the benefits of insurance if you have one. Remember, you are not alone in this journey.
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