PMS11 The Economic Burden of Osteoarthritis — Estimates of Direct and Indirect Costs in Sweden from the Biscuits Study

Abstract

To estimate annual incremental costs of healthcare use and productivity loss due to osteoarthritis (OA) in Sweden. Data from ‘BISCUITS’, a large Nordic cohort study linking several registries, were used to estimate differences in average direct and indirect costs between patients with OA and controls (matched 1:1 based on age and sex) from the general population in Sweden for 2017. Patients ≥18 years with ≥1 diagnosis of OA (ICD-10: M15-M19) recorded in speciality or primary care (latter available for subset of patients) during 2011-2017 were included. Patients with a diagnosis of cancer (ICD-10: C00-C43/C45-C97) were excluded. Productivity loss (sick leave and disability pension) and associated indirect costs was estimated among working-age adults (18-64 years). In 2017, the incremental average annual costs of specialist healthcare use, drug use and productivity loss among adults with OA (n=489,393) relative to those without OA (n=489,393) were €2,935 per patient (p<0.001; average cost, OA: €6,688; controls: €3,753). Direct cost differences (€1,459; p<0.001) were mainly explained by higher surgery cost due to OA patients having more surgeries (€765; p<0.001). For the working-age population, cost difference associated with work absence (€2,878; p<0.001) constituted 66% of the total cost difference between patients with OA and controls (€4,370; p<0.001). In a subset of patients with primary care data (OA, n=194,548; controls, n=194,548), the cost difference of primary care (€481; p<0.001) constituted 44% of the difference in total direct costs (€1,106; p<0.001). From a societal perspective, the economic burden of OA is substantial within both specialty care and primary care populations in Sweden. With an anticipated increasing prevalence due to an ageing population and higher presence of risk factors such as obesity and reduced physical activity, finding more effective and safer therapeutic strategies for these patients will be important.