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      The Global Economic Cost of Osteoarthritis: How the UK Compares

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      * , , , ,
      Arthritis
      Hindawi Publishing Corporation

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          Abstract

          Aims. To examine all relevant literature on the economic costs of osteoarthritis in the UK, and to compare such costs globally. Methods. A search of MEDLINE was performed. The search was expanded beyond peer-reviewed journals into publications by the department of health, national orthopaedic associations, national authorities and registries, and arthritis charities. Results. No UK studies were identified in the literature search. 3 European, 6 North American, and 2 Asian studies were reviewed. Significant variation in direct and indirect costs were seen in these studies. Costs for topical and oral NSAIDs were estimated to be £ 19.2 million and £ 25.65 million, respectively. Cost of hip and knee replacements was estimated to exceed £ 850 million, arthroscopic surgery for osteoarthritis was estimated to be £ 1.34 million. Indirect costs from OA caused a loss of economic production over £ 3.2 billion, £ 43 million was spent on community services and £ 215 million on social services for osteoarthritis. Conclusions. While estimates of economic costs can be made using information from non-published data, there remains a lack of original research looking at the direct or indirect costs of osteoarthritis in the UK. Differing methodology in calculating costs from overseas studies makes direct comparison with the UK difficult.

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          Most cited references29

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          Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study.

          Prevention and control of disease and injury require information about the leading medical causes of illness and exposures or risk factors. The assessment of the public-health importance of these has been hampered by the lack of common methods to investigate the overall, worldwide burden. The Global Burden of Disease Study (GBD) provides a standardised approach to epidemiological assessment and uses a standard unit, the disability-adjusted life year (DALY), to aid comparisons. DALYs for each age-sex group in each GBD region for 107 disorders were calculated, based on the estimates of mortality by cause, incidence, average age of onset, duration, and disability severity. Estimates of the burden and prevalence of exposure in different regions of disorders attributable to malnutrition, poor water supply, sanitation and personal and domestic hygiene, unsafe sex, tobacco use, alcohol, occupation, hypertension, physical inactivity, use of illicit drugs, and air pollution were developed. Developed regions account for 11.6% of the worldwide burden from all causes of death and disability, and account for 90.2% of health expenditure worldwide. Communicable, maternal, perinatal, and nutritional disorders explain 43.9%; non-communicable causes 40.9%; injuries 15.1%; malignant neoplasms 5.1%; neuropsychiatric conditions 10.5%; and cardiovascular conditions 9.7% of DALYs worldwide. The ten leading specific causes of global DALYs are, in descending order, lower respiratory infections, diarrhoeal diseases, perinatal disorders, unipolar major depression, ischaemic heart disease, cerebrovascular disease, tuberculosis, measles, road-traffic accidents, and congenital anomalies. 15.9% of DALYs worldwide are attributable to childhood malnutrition and 6.8% to poor water, and sanitation and personal and domestic hygiene. The three leading contributors to the burden of disease are communicable and perinatal disorders affecting children. The substantial burdens of neuropsychiatric disorders and injuries are under-recognised. The epidemiological transition in terms of DALYs has progressed substantially in China, Latin America and the Caribbean, other Asia and islands, and the middle eastern crescent. If the burdens of disability and death are taken into account, our list differs substantially from other lists of the leading causes of death. DALYs provide a common metric to aid meaningful comparison of the burden of risk factors, diseases, and injuries.
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            The economic burden of disabling hip and knee osteoarthritis (OA) from the perspective of individuals living with this condition.

            To estimate the direct and indirect arthritis-attributable costs to individuals with disabling hip and/or knee osteoarthritis (OA). An established population cohort with disabling hip and/or knee OA from two regions of Ontario, Canada was surveyed to determine participant and caregiver costs related to OA, and the predictors of these costs. The response rate was 87.2%. Of 1378 respondents, 1258 had OA (mean age 73.1 yr, range 59-100). Sixty per cent (n = 758) reported OA-related costs. Among these individuals, the average annual cost was 12,200 dollars(CDN dollars in 2002, where 1.00 CDN dollar approximately 0.81 US dollar). Time lost from employment and leisure by participants and their unpaid caregivers accounted for 80% of the total. Men were less likely than women to report costs (adjusted odds ratio 0.54, P or = 55 were 15 times more likely to report costs, and their costs were 3 times greater (both P < 0.0001). Both the young (<65 yr) and very old were more likely to incur costs (P < 0.0001), and when they did their costs were higher (P < 0.001). Costs incurred were mainly for time lost from employment and leisure, and for unpaid informal caregivers. Failure to value such indirect costs significantly underestimates the true burden of OA. Costs increased with worsening health status and greater OA severity. After adjustment, men were less likely to incur costs, possibly due to greater social resources.
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              The impact of osteoarthritis: implications for research.

              Osteoarthritis, the clinical syndrome of joint pain and dysfunction caused by joint degeneration, affects more people than any other joint disease. There are no consistently effective methods for preventing osteoarthritis or slowing its progression, and symptomatic treatments provide limited benefit for many patients. Osteoarthritis disables about 10% of people who are older than 60 years, compromises the quality of life of more than 20 million Americans, and costs the United States economy more than $60 billion per year. The incidence of osteoarthritis rises precipitously with age; as a result, the prevalence and burden of this disorder is increasing rapidly. Study of the patterns osteoarthritis incidence and prevalence shows that it occurs frequently in the hand, foot, knee, spine and hip, but rarely in the ankle, wrist, elbow, and shoulder, and the most important universal risk factors are age, excessive joint loading, and joint injury. Analysis of the impact of osteoarthritis raises questions that include: Why does the incidence increase progressively with age? Why are some joints rarely affected? How do mechanical forces cause joint degeneration? What biologic and mechanical factors slow or accelerate the rate of joint degeneration? Answering these questions could lead to effective methods of preventing osteoarthritis and slowing its progression.
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                Author and article information

                Journal
                Arthritis
                Arthritis
                ARTH
                Arthritis
                Hindawi Publishing Corporation
                2090-1984
                2090-1992
                2012
                2 October 2012
                : 2012
                : 698709
                Affiliations
                MSK Lab, Imperial College, London W6 8RF, UK
                Author notes

                Academic Editor: Charles J. Malemud

                Article
                10.1155/2012/698709
                3467755
                23082249
                0c0d09ef-419c-4a62-a7f9-1f716872580c
                Copyright © 2012 A. Chen et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 May 2012
                : 30 August 2012
                Categories
                Review Article

                Rheumatology
                Rheumatology

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