Impact of incident rheumatoid arthritis on earnings: a nationwide sibling comparison study.

objectivesRA is known to impact work ability, but much of this knowledge comes from historical comparisons vs the general population that neither reflects current RA management nor distinguishes between effects of RA and pre-existing socio-economic conditions of patients. We therefore aimed to examine earnings of patients before and after RA diagnosis, using recent data and sibling comparisons.

methodsSwedish register data were used including demographic information and healthcare utilization. Participants were patients with RA (aged 30-60 years, diagnosed with RA between 2006 and 2017) identified in the Swedish National Patient Register, and their same-sex siblings (n = 2433:2433; mean 48 years; 72% women). Earnings data for 2001-2019 were retrieved from Statistics Sweden and analysed from 5 years before to 5 years after RA diagnosis.

resultsNo differences in average earnings were observed between siblings during the 5 years before diagnosis, but during the 5 years after diagnosis, patients with RA earned on average 5.4% less annually [-1430€ (95% CI -2130, -720)] than same-sexed siblings. The change in earnings for the subgroup diagnosed between 2006 and 2010 was -8.2% [-2020€ (95% CI -2930, -1120)] but for patients diagnosed between 2011 and 2017, there was no statistically significant change in earnings compared with siblings [-1.5%; -420€ (95% CI -1490, 640)]. Subgroup analyses demonstrated a more negative impact on earnings for older individuals and those with lower education level.

conclusionRA diagnosis was associated with lower earnings in comparison with same-sex siblings, particularly for older individuals and those with lower education level. The negative impact of RA on earnings declined or disappeared over the study period.