Quantifying the Economic Burden of Osteoarthritis in Portugal: Insights From a Patient Journey Model
Author(s)
Ana Sofia Silva, MSc1, Pedro Cardoso, MSc1, Patrícia Redondo, MSc1, Joana Sousa, MSc1, Joana Oliveira Fagundes, MSc2.
1MOAI Consulting, Lisboa, Portugal, 2Johnson & Johnson MedTech, Porto Salvo, Portugal.
1MOAI Consulting, Lisboa, Portugal, 2Johnson & Johnson MedTech, Porto Salvo, Portugal.
OBJECTIVES: Osteoarthritis(OA) is a chronic, progressive joint disease and one of the leading causes of disability worldwide, particularly among elderly. This study aimed to assess OA (knee and hip) economic impact in Portugal by quantifying direct and indirect costs and mapping the patient journey through healthcare system.
METHODS: A mixed-method approach combined desk research, key opinion leaders(KOLs) interviews (n=12) and a structured micro cost model. The patient journey (from symptom onset to diagnosis, treatment, and follow-up) was validated by KOLs and costed using national tariffs and market estimates. Prevalence and severity distribution were based on longitudinal registry-based study(EpiReumaPT) and international sources. Indirect costs, including absenteeism, were estimated from productivity loss in working-age individuals with moderate-to-severe OA. Deterministic sensitivity analysis(DSA) was conducted to assess cost variability across parameters.
RESULTS: The cost per treated patient was estimated at €1,610, including €967 of direct costs, €440 of physiotherapy (for surgical patients) and 203€ of surgery related absenteeism. Untreated patients cost 1,018€/year, with indirect costs due to productivity losses of €817/patient and patient out-of-pocket expenses of 201€/patient. Knee OA emerged as the main cost driver, >€1 billion in total national burden. Surgery and physiotherapy showed potential for long-term cost mitigation. DSA revealed that absenteeism and OA prevalence among working-age adults were the most influential cost drivers. Each OA patient costs 4459€ and total cost for society and the payer was estimated in 5.6 billion euros possibly reaching 7.7 billion euros in the most expensive scenario.
CONCLUSIONS: OA imposes a considerable economic burden on Portugal’s healthcare system and society, largely due to direct treatment costs and lost productivity. Early intervention and improved access to surgical and non-pharmacological strategies (e.g. physiotherapy) can reduce long-term costs and improve quality of life. These findings support the need for policy prioritization of OA management within the national health strategy.
METHODS: A mixed-method approach combined desk research, key opinion leaders(KOLs) interviews (n=12) and a structured micro cost model. The patient journey (from symptom onset to diagnosis, treatment, and follow-up) was validated by KOLs and costed using national tariffs and market estimates. Prevalence and severity distribution were based on longitudinal registry-based study(EpiReumaPT) and international sources. Indirect costs, including absenteeism, were estimated from productivity loss in working-age individuals with moderate-to-severe OA. Deterministic sensitivity analysis(DSA) was conducted to assess cost variability across parameters.
RESULTS: The cost per treated patient was estimated at €1,610, including €967 of direct costs, €440 of physiotherapy (for surgical patients) and 203€ of surgery related absenteeism. Untreated patients cost 1,018€/year, with indirect costs due to productivity losses of €817/patient and patient out-of-pocket expenses of 201€/patient. Knee OA emerged as the main cost driver, >€1 billion in total national burden. Surgery and physiotherapy showed potential for long-term cost mitigation. DSA revealed that absenteeism and OA prevalence among working-age adults were the most influential cost drivers. Each OA patient costs 4459€ and total cost for society and the payer was estimated in 5.6 billion euros possibly reaching 7.7 billion euros in the most expensive scenario.
CONCLUSIONS: OA imposes a considerable economic burden on Portugal’s healthcare system and society, largely due to direct treatment costs and lost productivity. Early intervention and improved access to surgical and non-pharmacological strategies (e.g. physiotherapy) can reduce long-term costs and improve quality of life. These findings support the need for policy prioritization of OA management within the national health strategy.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE625
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Study Approaches
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Work & Home Productivity - Indirect Costs
Disease
Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), No Additional Disease & Conditions/Specialized Treatment Areas