OBJECTIVES: No up-to-date information since a decade about direct and out-of-pocket (OOP) healthcare expenditures among US adults with arthritis exists. Hence, we evaluated retrospective cross-sectional trends in incremental direct and OOP healthcare expenditures among adults with arthritis using a nationally representative data, the Medical Expenditures Panel Survey. METHODS: Study population comprised of bi-annual cross-sectional cohorts of individuals aged ≥ 18 years during calendar year of 2005 through 2014. Total direct and OOP healthcare expenditures per person per year were estimated. Two-part models were used to estimate the incremental total and types of annual direct and OOP healthcare expenditures (adjusted to 2014 US dollars) of arthritis after adjusting for predisposing, enabling, need, personal health practice and external environment factors as per the Anderson Healthcare Behavior Model. RESULTS: Annual weighted population of individuals with arthritis rose from 44.3 million in 2005/06 to 63.5 million in 2013/14. The unadjusted annual average direct and OOP expenditure were $10,963 (Standard Error, SE: $292, aggregated: $485.7 billion) and $1,949 (SE: $57, aggregated: $86.3 billion) in 2005/06 while these were $10,036 (SE: $237, total: 637.3 billion) and $1,177 (SE: $37, aggregated: 74.8 billion) in 2013/14, respectively, among individuals with arthritis. The incremental direct expenditures among adults with arthritis were $1,061 (SE: $198) in 2005/06 which reduced to $652 (SE: $172) in 2013/14. As compared to the direct and OOP expenditures in 2005/06, there was a significant decline in these estimates in 2013/2014. CONCLUSIONS: Although there was a decline in the intensity of incremental direct and OOP expenditures among individuals with arthritis in the recent years, arthritis still pose significant economic burden to the US.