400,000 individuals have multiple sclerosis nation-
ally. According to the Multiple Sclerosis Society, the 
average annual cost of multiple sclerosis to each af-
fected individual is approximately $50,000, and the 
total cost can exceed $3,000,000 over an individual’s 
lifetime. The annual cost of treating all people who 
suffer from multiple sclerosis in the United States is 
approximately $20,000,000,000. 
(14) Four million Americans suffer from 
Sjo¨gren’s syndrome, a serious autoimmune disease. 
Ninety percent of those with Sjo¨gren’s syndrome are 
women. Sjo¨gren’s affects all races and ethnic groups. 
Hallmark symptoms of Sjo¨gren’s include dry eyes 
and dry mouth, which can lead to corneal abrasions 
and blindness and loss of teeth if not recognized and 
treated and affect a persons’ ability to eat, swallow, 
and digest food. Sjo¨gren’s syndrome is a systemic 
disease that can affect any body organ or system, 
cause extreme fatigue and pain, and lead to develop-
ment of non-Hodgkin’s B-cell lymphoma and heart 
block in babies born to mothers with Sjo¨gren’s syn-
drome. 
Sjo¨gren’s 
syndrome 
is 
frequently 
misdiagnosed because of lack of recognition and phy-
sician education. According to the Sjo¨gren’s Syn-
drome Foundation, the average time for those who 
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do obtain a correct diagnosis is 6.3 years after the 
onset of symptoms and active attempt to obtain a di-
agnosis. 
(15) In rheumatoid arthritis, the immune sys-
tem attacks the linings of the joints resulting in 
joint pain, stiffness, swelling, and destruction. 
Among the 2,100,000 people with rheumatoid arthri-
tis in the United States, women outnumber men 3 
to 1. According to the Arthritis Foundation, total di-
rect costs of rheumatoid arthritis, including money 
spent on treatments, hospitalizations, medications, 
transportation, and specialist aids, are approxi-
mately $1,200,000,000 each year. The average med-
ical care expenditures over the course of a rheu-
matoid arthritis patient’s lifetime is $225,000 to 
$370,000. 
(16) Systemic sclerosis affects approximately 
240 individuals per million, and an estimated 
300,000 are affected by all forms of scleroderma in 
the United States. Scleroderma strikes more women 
than men, with an overall ratio of approximately 4 
to 1. Scleroderma is a chronic, often progressive 
autoimmune disease. The disease, which literally 
means ‘‘hard skin’’, can cause thickening and tight-
ening of the skin, as well as fibrosis of the internal 
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organs, including the lungs, heart, kidneys, and gas-
trointestinal tract. Scleroderma can be life threat-
ening. The Scleroderma Foundation estimates the 
direct and indirect costs of systematic sclerosis in 
the United States to be $1,500,000,000, the value of 
lifetime earnings lost to be $300,000 per systemic 
sclerosis death, and direct costs at $4,731 per pa-
tient annually. 
(17) Fibromyalgia is believed to affect approxi-
mately 3,700,000 people (approximately 2 percent of 
the United States population) and occurs more com-
monly in women than men. Current research sup-
ports a high correlation of those diagnosed with 
fibromyalgia also diagnosed with an autoimmune 
disease. Symptoms usually occur first between the 
ages of 20 to 40 years old. Fibromyalgia is wide-
spread pain and tenderness, fatigue, and exhaustion 
after minimal effort. Fibromyalgia is a lifelong dis-
order, with more than 90 percent of patients re-
maining symptomatic. Nearly 30 percent of patients 
claim they cannot hold steady employment due to 
their condition. The total yearly drain on the United 
States 
economy 
is 
estimated 
to 
be 
over 
$20,000,000,000. 
About 
16.2 
percent 
of 
fibromyalgia patients draw Social Security disability 
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payments. The average health care cost per patient 
per year is close to $2,300. 
(18) Myasthenia gravis is an autoimmune neu-
romuscular disease which affects the skeletal mus-
cles and is characterized by muscular weakness 
which is the result of a disturbance of the neuro-
muscular transmission. Certain muscles are more 
frequently involved, and these include the muscles 
that control eye movement, eyelids, chewing, swal-
lowing, coughing, and facial expression. Muscles that 
control breathing and movement of the arms and 
legs may also be affected. Approximately 40 to 50 
percent of individuals with myasthenia gravis experi-
ence vision problems at the time of diagnosis, and 
up to 90 percent experience such problems in the 
disease’s lifetime. About 40 to 50 percent of patients 
experience generalized myasthenia gravis affecting 
the muscles of the trunk or limbs, which may result 
in impaired breathing. The prevalence of myasthenia 
gravis in the Untied States is estimated at approxi-
mately 36,000 cases. However, myasthenia gravis is 
probably underdiagnosed, and the prevalence is 
probably higher. Previous studies have shown that 
women are more often affected than men; however, 
now it seems that males over 50 are more often af-
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fected. The most common age at onset is under-
before age 40 in women and after age 50 in men. 
Treatment for myasthenia gravis can cost up to 
$524 per month per prescription. Various surgeries 
can cost up to $6,000. 
(19) Wegener’s granulomatosis (WG) strikes 1 
in every 20,000 to 30,000 people. The disease can 
occur at any age, although peak occurrence is in the 
4th or 5th decade of life. Males and females are af-
fected equally. Wegener’s granulomatosis is a rare 
form of vasculitis, a disease characterized by inflam-
mation of blood vessel walls which can damage vital 
organs by restricting blood flow. Wegener’s granu-
lomatosis primarily affects the respiratory tract 
(sinus, nose, trachea, and lungs) and the kidneys 
and may involve the joints, eyes, and skin. According 
to the Wegener’s Granulomatosus Association, pa-
tients experience a 26 percent reduction in income 
within the first year of diagnosis, or $9,700,000 per 
year in lost income total for all Wegener’s patients. 
A 1998 survey of Wegener’s patients showed costs 
of $33,517 per patient per year. 
(20) In immune thrombocytopenic purpura 
(ITP), the body mounts an autoimmune attack 
against platelets, particles in the blood essential for 
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clotting. People with immune thrombocytopenic pur-
pura are prone to spontaneous hemorrhages, poten-
tially in the brain and other vital organs. According 
to the Platelet Disorders Support Association, treat-
ing immune thrombocytopenic purpura costs from 
several thousand to hundreds of thousands of dollars 
per year, depending on the severity of the case and 
response to treatments. Immune thrombocytopenic 
purpura is a diagnosis of exclusion. Many other dis-
eases and conditions present with low platelets and 
can be confused with immune thrombocytopenic pur-
pura. 
(21) According to the National Alopecia Areata 
Foundation, over 4,500,000 Americans have alopecia 
areata, alopecia totalis, or alopecia universalis, or 
1.7 percent of any given population. While children 
are affected most frequently, alopecia areata occurs 
in all ages and ethnicities and in males and females. 
Alopecia areata results in hair loss, with many peo-
ple losing all hair over their entire body, including 
eyebrows and eyelashes and the hair on their head. 
This leads to loss of self-esteem and filtering protec-
tion from the elements and cold. Denting and strip-
ping of nails can also occur along with complete nail 
loss. Since no approved treatments exist for alopecia 
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areata, insurance companies fail to recognize its se-
riousness and do not cover treatments that could af-
fect the disease’s course. Treatments are often paid 
for by patients or not administered. Diagnosis is dif-
ficult because of lack of knowledge, especially among 
pediatricians and general practitioners who would 
refer patients to specialists. The International 
Pemphigus Foundation estimates the incidence of 
pemphigus and pemphigoid as between 1 and 5 peo-
ple per hundred thousand. These diseases affect all 
races and ethnic groups. Pemphigus and pemphigoid 
are a group of chronic, rare autoimmune blistering 
diseases of the skin or mucous membranes. They are 
characterized by painful, burn-like blisters or lesions 
covering much of the body that do not heal, and 
they can cause serious infection, difficulty swal-
lowing, and, with cicatricial pemphigoid (CP), blind-
ness. If untreated, pemphigus is usually fatal. 
(22) Polymyositis is an autoimmune disease 
that causes inflammation of the small and medium- 
sized arteries and leads to problems in the muscles, 
joints, intestines, nerves, kidney, and skin. Myositis 
is a neuromuscular autoimmune disease affecting 
about 50,000 Americans. Because it is rare and not 
easily detectable, individuals with myositis are often 
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misdiagnosed. It is common for those with myositis 
to go either undiagnosed or misdiagnosed for several 
years before getting a correct diagnosis. The efficacy 
of treatment is diminished by delayed diagnoses and 
the resulting medications required and costs in-
curred are substantially higher. 
(23) More than 5,000,000 people in the United 
States have been diagnosed with psoriasis or psori-
atic arthritis, including children. Psoriasis is a life-
long skin disease that occurs when faulty signals in 
the immune system cause skin cells to regenerate too 
quickly. Extra skin cells build up on the skin’s sur-
face forming red, flaky, scaly lesions that can itch, 
crack, bleed, and be extremely painful. Psoriasis 
generally appears on the joints, limbs, and scalp, but 
it can appear anywhere, covering some people from 
head to toe. The National Psoriasis Foundation esti-
mates the cost of psoriasis care in the United States 
ranges from $650,000,000 a year to $4,300,000,000 
a year. A recent study estimates that Americans 
with psoriasis lose about 56 million hours of work 
and spend $2 to $3 billion to treat the disease each 
year. 
(24) Sarcoidosis results in small growths of 
blood vessels, cells, and connective tissue and leads 
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to problems in the skin, lungs, eyes, joints, and mus-
cles. Sarcoidosis is a disease due to inflammation 
that can attack any organ in the body in any loca-
tion. The disease is characterized by the presence of 
granulomas, small areas of inflamed cells. They can 
be either inside the body or on the body’s exterior, 
appearing as sores on the face or shins. Sarcoidosis 
is most frequently found in the lungs. There are 
about 25,000 cases of sarcoidosis in the United 
States. African Americans have a higher risk for 
sarcoidosis than do other Americans. However, the 
disease occurs in every race in the United States and 
throughout the world, including in individuals of Eu-
ropean ancestry. Sarcoidosis occurs predominantly 
between the ages of 20 and 40 years of age. 
(25) Vitiligo affects 1 to 2 percent of the popu-
lation, or about 3 to 6 million Americans, and af-
fects every nationality, race, and gender equally. Vit-
iligo is an autoimmune disease in which the immune 
system mistakenly attacks the pigment cells in the 
skin. It appears as milky white patches and can 
occur anywhere on the body. Usually progressive, it 
can have a devastating impact on a patient’s mental 
state, especially in those with darker skin. Cost var-
ies by treatment. Treatment can cost up to $150 a 
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month for topical medications, $2,000 to $3,000 for 
a home unit for phototherapy, and up to $30 per 
doctor’s office visit 2 to 3 times per week. Laser 
treatments can cost $100 to $200 per treatment per 
area. Diagnosis can be extremely difficult, as loss of 
pigment occurs in several other conditions, and phy-
sician education is lacking. It can take several 
months or trips to several different dermatologists 
for a definitive diagnosis. 
SEC. 3. GRANTS TO INCREASE AWARENESS OF AUTO-
IMMUNE DISEASES. 
(a) PURPOSE.—The purpose of this section is to in-
crease awareness of autoimmune diseases, such as lupus, 
multiple sclerosis, rheumatoid arthritis, and fibromyalgia, 
in order to provide to the public a more complete under-
standing of these diseases, which affect 5 to 10 percent 
of the people in the United States. 
(b) AMENDMENTS.—Title III of the Public Health 
Service Act (42 U.S.C. 241 et seq.) is amended by insert-
ing after section 317S the following: 
‘‘SEC. 317T. (a) GRANTS TO INCREASE AWARENESS 
OF
AUTOIMMUNE
DISEASES.—The Secretary, acting 
through the Director of the Centers for Disease Control 
and Prevention, shall award grants to eligible entities to 
conduct public and professional awareness activities re-
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garding autoimmune diseases, such as lupus, multiple scle-
rosis, rheumatoid arthritis, and fibromyalgia. 
‘‘(b) USE OF FUNDS.—In conducting public and pro-
fessional awareness activities with a grant under this sec-
tion, an eligible entity may do any of the following: 
‘‘(1) Promote increased awareness of early 
intervention and treatment so as to significantly im-
prove the quality of life for people with autoimmune 
diseases, such as lupus, multiple sclerosis, rheu-
matoid arthritis, and fibromyalgia. 
‘‘(2) Target minority communities that may be 
underserved or disproportionately affected by auto-
immune diseases, such as lupus, multiple sclerosis, 
rheumatoid arthritis, and fibromyalgia. 
‘‘(3) Target women (who are disproportionately 
affected by autoimmune diseases, such as lupus, 
multiple 
sclerosis, 
rheumatoid 
arthritis, 
and 
fibromyalgia) so as to help reduce the amount of 
time taken for correct diagnosis of such diseases, 
which often takes more than 1 year. 
‘‘(c) ELIGIBLE ENTITY.—For purposes of this sec-
tion, the term ‘eligible entity’ means a nonprofit organiza-
tion, a consumer group, an institution of higher education 
(as defined in section 101 of the Higher Education Act 
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of 1965), a Federal, State, or local governmental agency, 
or a media organization. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$18,000,000 for each of fiscal years 2007 and 2008.’’. 
SEC. 4. GRANTS FOR EDUCATION ON RELATIONSHIP BE-
TWEEN AUTOIMMUNE DISEASES AND MEN-
TAL ILLNESSES. 
Title III of the Public Health Service Act (42 U.S.C. 
241 et seq.), as amended by section 3, is amended by in-
serting after section 317T the following: 
‘‘SEC. 317U. (a) GRANTS FOR EDUCATION ON RELA-
TIONSHIP BETWEEN AUTOIMMUNE DISEASES AND MEN-
TAL ILLNESSES.—The Secretary, acting through the Ad-
ministrator of the Health Resources and Services Admin-
istration, shall award grants to eligible entities for the 
education of health care providers on potential links be-
tween autoimmune diseases, such as lupus, multiple scle-
rosis, rheumatoid arthritis, and fibromyalgia, and cog-
nitive and mood disorders, such as depression. 
‘‘(b) ELIGIBLE ENTITY.—For purposes of this sec-
tion, the term ‘eligible entity’ means a nonprofit organiza-
tion, a consumer group, an institution of higher education 
(as defined in section 101 of the Higher Education Act 
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of 1965), a Federal, State, or local governmental agency, 
or a media organization. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$5,000,000 for each of fiscal years 2007 and 2008.’’. 
SEC. 5. LOAN REPAYMENT PROGRAM REGARDING PHYSI-
CIAN RESEARCH ON AUTOIMMUNE DISEASES. 
Title IV of the Public Health Service Act (42 U.S.C. 
281 et seq.) is amended— 
(1) by redesignating the second section 487F as 
section 487G; and 
(2) by inserting after section 487G (as so re-
designated) the following: 
‘‘SEC. 487H. LOAN REPAYMENT PROGRAM REGARDING PHY-
SICIAN RESEARCH ON AUTOIMMUNE DIS-
EASES. 
‘‘(a) ESTABLISHMENT.—To the extent and in the 
amounts provided in advance in appropriations Acts, the 
Secretary, acting through the Administrator of the Health 
Resources and Services Administration, shall establish a 
program to enter into contracts with qualified physicians 
under which such qualified physicians agree to conduct re-
search for a period of at least 3 years regarding auto-
immune diseases, such as lupus, multiple sclerosis, rheu-
matoid arthritis, and fibromyalgia, in consideration of the 
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Federal Government agreeing to repay, for each year of 
service conducting such research, not more than $35,000 
of the principal and interest of the educational loans of 
such qualified physicians. 
‘‘(b) APPLICATION OF PROVISIONS.—Except as in-
consistent with this section, the provisions of sections 
338B, 338C, and 338E shall apply to the program estab-
lished under this section to the same extent and in the 
same manner as such provisions apply to the National 
Health Service Corps Loan Repayment Program estab-
lished in subpart III of part D of title III. 
‘‘(c) QUALIFIED PHYSICIAN.—For purposes of this 
section, the term ‘qualified physician’ means any indi-
vidual who has received, or will have received by the time 
of the research to be conducted under this section, a de-
gree of doctor of medicine or its equivalent and is licensed 
to practice medicine in the United States. 
‘‘(d) FUNDING.— 
‘‘(1) AUTHORIZATION
OF
APPROPRIATIONS.— 
For the purpose of carrying out this section, there 
are authorized to be appropriated such sums as may 
be necessary for 2007 and each subsequent fiscal 
year. 
‘‘(2) AVAILABILITY.—Amounts appropriated for 
carrying out this section shall remain available until 
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the expiration of the second fiscal year beginning 
after the fiscal year for which the amounts were 
made available.’’. 
Æ 
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