Economic impact of lower-limb osteoarthritis worldwide: a systematic review of cost-of-illness studies

Abstract

International audienceObjectiveAn overview of the economic consequences – overall costs as well as cost breakdown (direct and indirect) – of hip and knee osteoarthritis (OA) worldwide.MethodsA systematic literature search of EMBASE, MEDLINE, Scopus and Cochrane databases for articles was performed independently by two rheumatologists who used the same predefined eligible criteria. Papers without abstracts and in languages other than English or French were excluded. Extracted costs were converted to an annual cost and to 2013 euros (€) by using the Consumer Price Index of the relevant countries and the 2013 Purchasing Power Parities between these countries and the European Union average.ResultsA total of 45 abstracts were selected, and 32 articles were considered for the review. The studied populations were heterogeneous: administrative, hospital and national health survey data. Annual total costs per patient ranged from 0.7 to 12 k€, direct costs per patient from 0.5 to 10.9 k€ and indirect costs per patient from 0.2 to 12.3 k€. The weighted average annual costs per patient living with knee and hip OA were 11.1, 9.5 and 4.4 k€ for total, direct and indirect costs, respectively.ConclusionsThis review highlights the heterogeneity of studies and lack of methodologic consensus to obtain reliable cost-of-illness estimates for lower-limb OA. However, costs induced by the disease seem substantial and deserve to be more extensively explored

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“…The number of patients with OA is expected to increase during the coming years in many countries, because life expectancy is also increasing, and OA differentially affects older adults (2). Nevertheless, the burden of OA is related not only to its major impact on lowering quality of life but also to the heavy economic costs associated with the disease in individuals and health care systems (3)(4)(5)(6)(7)(8)(9)(10). Common health care use associated with OA includes office visits, hospitalization, outpatient and inpatient costs, and surgical procedures (e.g., joint replacements).…”

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“…Osteoarthritis (OA) of the knee is one of the most common causes of debilitating joint disease (1). Moreover, the economic burden associated with treatment and loss of productivity is substantial (2). The course of disease varies considerably, and it is essential to identify valid biomarkers that can be used to accurately predict disease progression.…”