People in Tennessee with arthritis and other rheumatic conditions confront pain in their body, and in their lifestyle, according to a report card released this month from the American College of Rheumatology.
The college gives Tennessee a C grade in terms of quality of life and access to certified doctors in rheumatic disease, which is the grade most states received.
But Dr. Christopher Mecoli, a rheumatologist at The Johns Hopkins School of Medicine, says the state gets a D grade in affordability because most insurers require patients to pay for a percentage of their prescription cost, versus a flat rate.
"There are some issues as it pertains to affordability in Tennessee," he states. "Drugs used to treat rheumatic diseases can be extremely expensive. They can cost tens of thousands of dollars a year."
Rheumatic diseases include arthritis, gout and lupus, and 100 other conditions. The conditions impact 1 in 4 Americans, and the most recent numbers estimate 91 million people, including individuals who may be undiagnosed.
Treatment for the illnesses cost $140 billion annually, which exceeds the annual cost of cancer care.
Mecoli says that around 300,000 children have rheumatoid arthritis and adds there's a shortage of people in Tennessee trained to treat children.
"Rheumatic diseases are not just diseases effecting the elderly," he points out. "There are actually hundreds of thousands of children who live with arthritis and other rheumatic diseases. There are actually not nearly enough board-certified pediatric rheumatologists."
Nationwide, there is one rheumatologist for every 40,000 people, but in Tennessee there is one for every 55,000 people - making treatment particularly hard for the state's rural communities.