Insurer and Out-of-Pocket Costs of Osteoarthritis in the US Evidence From National Survey Data

De Puy, Inc., Warsaw, Indiana, USA.
Arthritis & Rheumatology (Impact Factor: 7.76). 12/2009; 60(12):3546-53. DOI: 10.1002/art.24984
Source: PubMed


Osteoarthritis (OA) is a major debilitating disease affecting approximately 27 million persons in the US. Yet, the financial costs to patients and insurers remain poorly understood. The purpose of this study was to quantify by multivariate analyses the relationships between OA and annual health care expenditures borne by patients and insurers.
Data from the Medical Expenditure Panel Survey (MEPS) for the years 1996-2005 were used. MEPS is a large, nationally representative US database that includes information on health care expenditures, medical conditions, health insurance status, and sociodemographic characteristics. Individual and nationally aggregated cost estimates are provided.
OA was found to contribute substantially to health care expenditures. Among women, OA increased out-of-pocket (OOP) expenditures by $1,379 per annum (2007 dollars) and insurer expenditures by $4,833. Among men, OA increased OOP expenditures by $694 per annum and insurer expenditures by $4,036. Given the high prevalence of OA, the aggregate effects on health care expenditures were very large. OA raised aggregate annual medical care expenditures by $185.5 billion. Of that amount, insurer expenditures were $149.4 billion and OOP expenditures were $36.1 billion. Because of the greater prevalence of OA in women and their more intensive use of health care, total expenditures for this group accounted for $118 billion, or almost two-thirds of the total increase in health care expenditures resulting from OA.
The health care cost burden associated with OA is quite large for all groups examined and is disproportionately higher for women. Although insurers bear the brunt of treatment costs for OA, the OOP costs are also substantial.

Download full-text


Available from: Candace Gunnarsson, Nov 11, 2014
  • Source
    • "Osteoarthritis (OA) is the most common joint disorder in the world [1]. In the United States, the symptomatic knee OA occurs in 10% of the male and 13% of the female population with 60 years of age or more, with an estimated financial burden of US$ 47.8 billion annually [2] [3]. In Brazil, this disease is estimated to affect 6% to 12% of the adults with more than one third of those aged 65 years or over [4]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Osteoarthritis (OA) is the most common joint disorder in the world. Among the mechanisms involved in osteoarthritis, biomarkers (cytokines profile) may be related to pain and pain intensity, functional capacity, and pressure pain thresholds (PPT). Thus, the study of these relationships may offer useful information about pathophysiology and associated mechanisms involved in osteoarthritis. Therefore, the objective of this study was to investigate the seric concentration of pro (IL-6, IL-8, and TNF-α) and anti-inflammatory (IL-10) cytokines in patients with painful knee osteoarthritis and to correlate the levels of these biomarkers with the patients’ functional capacity and pressure pain threshold (PPT) values.
    • "Adult articular cartilage is an avascular, load-bearing tissue that has limited capacity to heal following injury or degeneration. Osteoarthritis is the leading cause of disability in Americans and is associated with medical costs > ~$130 billion (Kotlarz et al., 2009; Luo et al., 2004). Successful biological repair of osteoarthritic (OA) or injured cartilage may reduce the need for artificial joint replacement by providing long-term pain relief and maintaining the mechanical function of the healthy native tissue. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Tissue-engineering techniques have been successful in developing cartilage-like tissues in vitro using cells from animal sources. The successful translation of these strategies to the clinic will likely require cell expansion to achieve sufficient cell numbers. Using a two-dimensional (2D) cell migration assay to first identify the passage at which chondrocytes exhibited their greatest chondrogenic potential, the objective of this study was to determine a more optimal culture medium for developing three-dimensional (3D) cartilage-like tissues using human cells. We evaluated combinations of commonly used growth factors that have been shown to promote chondrogenic growth and development. Human articular chondrocytes (AC) from osteoarthritic (OA) joints were cultured in 3D environments, either in pellets or encapsulated in agarose. The effect of growth factor supplementation was dependent on the environment, such that matrix deposition differed between the two culture systems. ACs in pellet culture were more responsive to bone morphogenetic protein (BMP2) alone or combinations containing BMP2 (i.e. BMP2 with PDGF or FGF). However, engineered cartilage development within agarose was better for constructs cultured with TGFβ3. These results with agarose and pellet culture studies set the stage for the development of conditions appropriate for culturing 3D functional engineered cartilage for eventual use in human therapies. Copyright © 2015 John Wiley & Sons, Ltd.
    Journal of Tissue Engineering and Regenerative Medicine 01/2015; DOI:10.1002/term.1988 · 5.20 Impact Factor
  • Source
    • "An estimated 27 million people in the United States (US) have OA [1], and nearly half of all Americans are projected to develop knee OA during their lifetime [2]. Based on the US Medical Expenditure Panel Survey, associated insurer and out of pocket healthcare costs account for more than $185 billion per year with another $10 billion lost from absenteeism at work [3, 4]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: BackgroundKnee osteoarthritis (OA) causes pain and long-term disability with annual healthcare costs exceeding $185 billion in the United States. Few medical remedies effectively influence the course of the disease. Finding effective treatments to maintain function and quality of life in patients with knee OA is one of the national priorities identified by the Institute of Medicine. We are currently conducting the first comparative effectiveness and cost-effectiveness randomized trial of Tai Chi versus a physical-therapy regimen in a sample of patients with symptomatic and radiographically confirmed knee OA. This article describes the design and conduct of this trial.Methods/DesignA single-center, 52-week, comparative effectiveness randomized controlled trial of Tai Chi versus a standardized physical-therapy regimen is being conducted at an urban tertiary medical center in Boston, Massachusetts. The study population consists of adults ≥ 40 years of age with symptomatic and radiographic knee OA (American College of Rheumatology criteria). Participants are randomly allocated to either 12 weeks of Tai Chi (2x/week) or Physical Therapy (2x/week for 6 weeks, followed by 6 weeks of rigorously monitored home exercise). The primary outcome measure is pain (Western Ontario and McMaster Universities WOMAC) subscale at 12 weeks. Secondary outcomes include WOMAC stkiffness and function domain scores, lower extremity strength and power, functional balance, physical performance tests, psychological and psychosocial functioning, durability effects, health related quality of life, and healthcare utilization at 12, 24 and 52 weeks.DiscussionThis study will be the first randomized comparative-effectiveness and cost-effectiveness trial of Tai Chi versus Physical Therapy in a large symptomatic knee OA population with long-term follow up. We present here a robust and well-designed randomized comparative-effectiveness trial that also explores multiple outcomes to elucidate the potential mechanisms of mind-body effect for a major disabling disease with substantial health burdens and economic costs. Results of this study are expected to have important public health implications for the large and growing population with knee OA.Trial identifier: NCT01258985Electronic supplementary materialThe online version of this article (doi:10.1186/1472-6882-14-333) contains supplementary material, which is available to authorized users.
    BMC Complementary and Alternative Medicine 09/2014; 14(1):333. DOI:10.1186/1472-6882-14-333 · 2.02 Impact Factor
Show more