GLOBAL AND REGIONAL ESTIMATES OF CLINICAL AND ECONOMIC BURDEN OF OSTEOARTHRITIS IN LOW- AND MIDDLE-INCOME COUNTRIES: A SYSTEMATIC REVIEW
Author(s)
Francis Fatoye, BSc, MBA, MSc, PhD1, Chidozie E. Mbada, BSc, MBA, MSc, PhD1, Clara T. Fatoye, BSc, MA, Other1, Zalmai Hakimi, PharmD, PhD2, Ushotanefe Useh, BSc, MSc, PhD3, Tadesse Gebrye, MPH, MSc1;
1Manchester Metropolitan University, Manchester, United Kingdom, 2Sobi, Amsterdam, Netherlands, 3North‒West University, Potchefstroom, South Africa
1Manchester Metropolitan University, Manchester, United Kingdom, 2Sobi, Amsterdam, Netherlands, 3North‒West University, Potchefstroom, South Africa
OBJECTIVES: This review aimed to synthesise evidence on the clinical and economic burden of osteoarthritis (OA) within low- and middle-income countries (LMICs).
METHODS: A systematic search was undertaken in line with PRISMA guidelines across PubMed, Medline, CINAHL, PsycINFO, Global Health Economics, and Scopus databases from inception to November 12, 2025. Eligible studies were examining clinical and economic burden of OA in LMICs which were published in English language. The methodological quality of the selected studies was evaluated using the Newcastle-Ottawa Scale for cohort studies.
RESULTS: The search yielded 752 potentially relevant records, of which 10 studies (Asia (n = 5), Latin America (n=3), Eastern Europe (n=1), and Sub-Saharan Africa (n=1)) met the inclusion criteria. Sample size ranged from 112 to 184,363 participants. Most studies examined knee OA in adults aged ≥40 years, with women accounting for 60-81% of cases. Across studies, hospitalisation patterns varied: one reported higher hospitalisation among arthritis patients (28.9%) versus non‑arthritis groups (22.2%), while surgical cohorts (total knee arthroplasty) had universal inpatient admission, with 29.7% entering via emergency and 70.3% through elective pathways. Outpatient use was substantial, with 22.7% reporting one visit, 34.3% two to three visits, and 43% four or more visits annually; hospital stay ranged from a median of 3 days to a mean of 10.3 days. Reported annual per-patient costs ranged from USD 685 to USD 1,272-1,324. Where reported, direct medical costs comprised 70-76% of total costs, while indirect costs due to productivity loss accounted for 24-29%.
CONCLUSIONS: Osteoarthritis imposes a substantial clinical and economic burden across LMICs, reflected in high healthcare utilisation, variable hospitalisation patterns, and significant annual per‑patient costs dominated by direct medical expenses. This is the first review, and it shows limited and methodologically inconsistent evidence base highlighting the need for more robust, context-specific economic evaluations to better guide policy and resource allocation.
METHODS: A systematic search was undertaken in line with PRISMA guidelines across PubMed, Medline, CINAHL, PsycINFO, Global Health Economics, and Scopus databases from inception to November 12, 2025. Eligible studies were examining clinical and economic burden of OA in LMICs which were published in English language. The methodological quality of the selected studies was evaluated using the Newcastle-Ottawa Scale for cohort studies.
RESULTS: The search yielded 752 potentially relevant records, of which 10 studies (Asia (n = 5), Latin America (n=3), Eastern Europe (n=1), and Sub-Saharan Africa (n=1)) met the inclusion criteria. Sample size ranged from 112 to 184,363 participants. Most studies examined knee OA in adults aged ≥40 years, with women accounting for 60-81% of cases. Across studies, hospitalisation patterns varied: one reported higher hospitalisation among arthritis patients (28.9%) versus non‑arthritis groups (22.2%), while surgical cohorts (total knee arthroplasty) had universal inpatient admission, with 29.7% entering via emergency and 70.3% through elective pathways. Outpatient use was substantial, with 22.7% reporting one visit, 34.3% two to three visits, and 43% four or more visits annually; hospital stay ranged from a median of 3 days to a mean of 10.3 days. Reported annual per-patient costs ranged from USD 685 to USD 1,272-1,324. Where reported, direct medical costs comprised 70-76% of total costs, while indirect costs due to productivity loss accounted for 24-29%.
CONCLUSIONS: Osteoarthritis imposes a substantial clinical and economic burden across LMICs, reflected in high healthcare utilisation, variable hospitalisation patterns, and significant annual per‑patient costs dominated by direct medical expenses. This is the first review, and it shows limited and methodologically inconsistent evidence base highlighting the need for more robust, context-specific economic evaluations to better guide policy and resource allocation.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE29
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Work & Home Productivity - Indirect Costs
Disease
SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)