Although guidelines do not recommend use of opioids to manage pain for individuals with knee osteoarthritis, a recent study published early online in Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Professionals, estimates that 858,000 Americans use opioids such as tramadol and oxycodone for their knee pain, equating to $14 billion in lifetime opioid-related societal costs, or nearly $0.5 billion annually.
A team led by Elena Losina, PhD, Robert W. Lovett Professor of Orthopedic Surgery, of Brigham and Women's Hospital, used a computer simulation to estimate the annual and lifetime contribution of opioids to knee osteoarthritis-related costs. The researchers show the direct medical cost of knee osteoarthritis treatment including opioids totals $7.45 billion or 53 percent of the total lifetime costs. The remaining 47 percent of lifetime costs to society is used to pay for lost productivity at work, criminal justice expenses due to opioid use disorders among patients with knee osteoarthritis and cost associated with diversion activities related to illicit use by others.
For an individual patient who used opioids to treat their knee osteoarthritis, the lifetime opioid-related cost was estimated at $13,770. "Given larger number of patients with knee osteoarthritis using opioids, our results provide additional evidence of the substantial economic burden of opioid use for knee osteoarthritis pain management and the potential savings from preventing opioid use," said Dr. Losina.
The results reveal a substantial economic burden of opioid use among patients with knee osteoarthritis, and they indicate that substantial savings can result from following current guidelines recommending against such use.
"The most important part of our study is that we estimated that almost half of the total societal cost of opioid use in persons with symptomatic knee osteoarthritis is used to pay for lost work productivity and criminal justice and other consequences of the diversion of prescribed opiates to unlawful use," concludes Dr. Losina. "These data offer new evidence of the magnitude of the societal burden generated by opioid use and misuse and could be used to educate health care providers and health policy decision makers on the best alternatives to opiate use."
