Cost of Osteoarthritis
Osteoarthritis is widespread and costly – both to individuals and to the nation.
There is limited osteoarthritis (OA)-specific cost data and the majority of cost estimates reflect the total cost of all forms of arthritis. However, OA, which affects an estimated 32.8 million adults, is the most common form of the more than 100 different rheumatic conditions that comprise arthritis.2 The number of adults with OA is expected to increase as baby boomers age, because older adults have a higher prevalence of arthritis and OA.3 By 2040, the number of adults with arthritis is projected to increase to 78.4 million, most of whom will have OA.3 It is estimated that two-thirds of adults with obesity will develop knee OA at some point in their life, so rates of OA will increase with the obesity epidemic.15
How the Cost of OA Affects the Nation
OA has a significant economic impact due to the effects of disability, comorbid disease, and the expense of treatment.4
The United States Bone and Joint Initiative (USBJI) highlights the enormous economic impact of OA in their Burden of Musculoskeletal Diseases5 report:
- 33% of reported lost work days for medical conditions was due to arthritis-related conditions (172.1 million total work days lost).
- Incremental mean health care expenditures for arthritis-related conditions increased 192% from 1996 to 2011. Per-person medical costs attributed to OA and allied disorders averaged $11,029 per-year between 2008 to 2011.
- In 2010, there were 21.7 million ambulatory care visits and over 6.7 million inpatient hospitalizations for people with OA.
- In 2010 and 2011, there were an estimated 1.3 to 1.4 million joint replacements performed, the majority for people with OA.
- Despite a decline in length of hospital stay (mean of 9 days in 1992 to 3.5 days in 2010), USBJI reports that “total hospitalization charges for both knee replacements have more than quadrupled (in constant 2011 dollars) from $8.1 billion in 1998 to $38.5 billion in 2011.”
- Medical expenditures attributed to OA averaged $62.1 billion nationally in each year between 2008 and 2011.
- OA disproportionately affects women and minorities. More women than men have OA, particularly after age 50. Documented disparities include significantly greater adverse effects (activity limitation, work limitation, and severe pain) due to OA among African American compared to non-Hispanic white populations, despite equivalent OA prevalence between the two groups. Of increased concern, African Americans receive 39% fewer total knee replacements than whites despite similar levels of severe OA.16
How the Cost of Arthritis Affects the States
When broken down by state, information from 2003 shows total costs of arthritis ranged from $226 million in the District of Columbia to $12.1 billion in California.6
The states with the highest cost attributable to arthritis:
- California, $12.1 billion
- New York, $8.7 billion
- Texas, $8.7 billion
- Florida, $7.6 billion
- Pennsylvania, $6.5 billion
- Ohio, $5.7 billion
- Michigan, $5.5 billion
- North Carolina, $4.1 billion
- Georgia, $3.9 billion
- New Jersey, $3.5 billion
You can view the full rankings here.
THE OA ACTION ALLIANCE’S STATE FACT SHEETS FOR OSTEOARTHRITIS
We have developed fact sheets for each state in America about the burden of osteoarthritis. This can be a tool to advocate for osteoarthritis with your legislators, administrators, and others. Click here to download your state’s fact sheet.
How the Cost of OA Affects the Employer
While OA is more common among employees in certain occupations such as mining, construction, agriculture, and sectors of the service industry, OA can interfere with the ability to be productive while on any job.7,8
- Between 2010 and 2012, 3.8 million adults in the US with doctor-diagnosed arthritis reported they were unable to work due to their health, and 2.1 million adults reported they were limited in the kind or amount of work they could do.5 As the most common form of arthritis, it is likely that OA accounts for a large portion of those with work limitations.
- Total national arthritis-attributable lost wages were $164 billion in 2013.6 That amounts to $4,040 less pay for an adult with arthritis compared with an adult without arthritis.15
- OA severely limits productivity. Approximately 30% of adults age 18 to 64y with doctor-diagnosed arthritis report an arthritis-attributable work limitation,1 including working less or not working at all. Much of this is due to OA.
FURTHER RESOURCES ON THE BURDEN OF OA
- US Bone and Joint Initiative (USBJI): Burden of Musculoskeletal Disease in the US
- Prevalence, Societal and Economic Costs (3rd ed, report)
- Centers for Disease Control and Prevention (CDC): Arthritis Data and Statistics – National Statistics
- National Association of Chronic Disease Directors: Arthritis Council Records
- Center for Enhancing Activity & Participation among Persons with Arthritis (ENACT): Arthritis Information – General information about arthritis, socioeconomic burden, and treatment
- Objective physical activity measurement in the Osteoarthritis Initiative: Are guidelines being met? Dunlop, et al; Arthritis Rheum 2012 (full text)
- Prevalence of Obesity in the US, 2009-2010, Ogden, et al., NCHS Data Brief 2012 (full text)
- Disability, Arthritis, and Body Weight among Adults 45 Years and Older, Okoro, et al., Obes Res 2004 (abstract)
- What if We Prevent Obesity? Risk Reduction in Knee Osteoarthritis, Muthuri, et al., Arth Care Res 2011 (abstract)
- Barbour KE, Helmick CG, Boring M, Brady TJ. Vital Signs: Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation — United States, 2013–2015. MMWR Morb Mortal Wkly Rep 2017;66:246–253. DOI: http://dx.doi.org/10.15585/mmwr.mm6609e1.
- Cisternas MG, Murthy L, Sacks JJ, Solomon DH, Pasta DJ, Helmick CG. Alternative Methods for Defining Osteoarthritis and the Impact on Estimating Prevalence in a US Population-Based Survey. Arthritis Care Res (Hoboken). 2016 May;68(5):574-80.
- Hootman, J. M., Helmick, C. G., Barbour, K. E., Theis, K. A. and Boring, M. A. (2016), Updated Projected Prevalence of Self-Reported Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation Among US Adults, 2015–2040. Arthritis & Rheumatology, 68: 1582–1587. doi:10.1002/art.39692
- Bitton, R. (2009). The economic burden of osteoarthritis. Am J Manag Care, 15(8 Suppl), S230-S235.
- United States Bone and Joint Initiative: The Burden of Musculoskeletal Diseases in the United States (BMUS), Third Edition, 2014. Rosemont, IL. Available at http://www.boneandjointburden.org.
- Yucesoy B, Charles LE, Baker B, Burchfiel CM. Occupational and genetic risk factors for osteoarthritis: a review. Work 2015; 50(2):261-273.
- Silverwood,V., Blagojevic-Bucknall,M., Jinks,C., Jordan,J.L., Protheroe,J., & Jordan,K.P. (2015). Current evidence on risk factors for knee osteoarthritis in older adults: a systematic review and meta-analysis. Osteoarthritis Cartilage, 23(4), 507-515.
- A. Hawker, L. Stewart, M.R. French, J. Cibere, J.M. Jordan, L. March, et al. Understanding the pain experience in hip and knee osteoarthritis–an OARSI/OMERACT initiative. Osteoarthritis Cartilage, 16 (2008), pp. 415–422
- Vos,T et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 380(9859), 2163-2196.
- Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis 2014; 73(7):1323-1330.
- Dillon CF, Rasch EK, Gu Q, Hirsch R. Prevalence of knee osteoarthritis in the United States: Arthritis data from the Third National Health and Nutrition Examination Survey 1991-1994. J Rheumatol, 2006;33(11):2271-2279.
- Bolen J, Hootman J, Helmick CG, Murphy L, Langmaid G, Caspersen CJ. Arthritis as a potential barrier to physical activity among adults with diabetes – United States, 2005 and 2007. Morbidity and Mortality Weekly Report 2008;57(18):486-489. http://www.cdc.gov/MMWR/preview/mmwrhtml/mm5718a3.htm
- Dunlop DD, Song J, Semanik PA, Chang RW, Sharma L, Bathon JM et al. Objective physical activity measurement in the osteoarthritis initiative: Are guidelines being met? Arthritis Rheum 2011; 63(11):3372-3382.
- Murphy L, Schwartz TA, Helmick CG, Renner JB, Tudor G, Koch G, et al. Lifetime risk of symptomatic knee osteoarthritis. Arthritis & Rheumatism 2008:59(9):1207-1213.
- Cisternas MG, Murphy L, Croft JB, Helmick CG. Racial disparities in total knee replacement among Medicare enrollees–United States 2000-2006. Morbidity and Mortality Weekly Report2009;58(6):133-138.
- Theis KA, Hootman JM, Helmick CG, Yelin E. Prevalence and correlates of arthritis-attributable work limitation in the US population among persons ages 18-64: 2002 National Health Interview Survey Data. Arthritis Care & Research 2007;57(3):355-363