A few state-level malpractice reforms had significantly affected the growth of individual-level health spending, and the direction and magnitude of the effects differed by type of reform.

With the number of approved drugs now available for the treatment of rheumatoid arthritis, there is an ever-increasing need for real-world, objective data to shed light on the comparative effectiveness and comparative safety of newly approved drugs versus other standard of care older medications. This chapter will provide an overview of voluntary rheumatoid arthritis (RA) registries that currently recruit patients and actively publish research findings. It will also highlight some of the key clinical insights derived from these voluntary registries. Voluntary registries have their own strengths and limitations compared to population-based registries. Unlike pharmaceutical sponsored clinical trials, the majority of these voluntary registries do not exclude patients based on comorbidities. Additionally, clinical trials are not always feasible on a large scale and have limited duration. Observational registries do not typically have these limitations.