University of Oulu

Hallberg, S., Rolfson, O., Karppinen, J., Schiøttz-Christensen, B., Stubhaug, A., Toresson Grip, E., Robinson, R., De Geer, A. & Schepman, P. (2023). Economic burden of osteoarthritis – multi-country estimates of direct and indirect costs from the BISCUITS study. Scandinavian Journal of Pain, 23(4), 694-704.

Economic burden of osteoarthritis : multi-country estimates of direct and indirect costs from the BISCUITS study

Saved in:
Author: Hallberg, Sara1; Rolfson, Ola2; Karppinen, Jaro3;
Organizations: 1Quantify Research, Stockholm, Sweden
2University of Gothenburg, Gothenburg, Sweden
3University of Oulu, Oulu, Finland
4University of Southern Denmark, Odense, Denmark
5Oslo University Hospital, Oslo, Norway
6University of Oslo, Oslo, Norway
7Karolinska Institute, Stockholm, Sweden
8Eli Lilly & Co., Indianapolis, IN, USA
9Pfizer AB, Sollentuna, Sweden
10Pfizer Inc., New York, NY, USA
Format: article
Version: published version
Access: embargoed
Persistent link:
Language: English
Published: De Gruyter, 2023
Publish Date: 2024-06-30


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 osteoarthritis and controls (matched 1:1 based on birth year and sex) from the general population in Sweden, Norway, Finland and Denmark for 2017. Patients ≥18 years with ≥1 diagnosis of osteoarthritis (ICD-10: M15–M19) recorded in specialty or primary care (the latter available for a subset of patients in Sweden and for all patients in Finland) during 2011–2017 were included. Patients with a cancer diagnosis (ICD-10: C00–C43/C45–C97) were excluded. Productivity loss (sick leave and disability pension) and associated indirect costs were estimated among working-age adults (18–66 years). In 2017, average annual incremental direct costs among adults with osteoarthritis (n=1,157,236) in specialty care relative to controls ranged between €1,259 and €1,693 (p<0.001) per patient across all countries. Total average annual incremental costs were €3,224–€4,969 (p<0.001) per patient. Healthcare cost differences were mainly explained by osteoarthritis patients having more surgeries. However, among patients with both primary and secondary care data, primary care costs exceeded the costs of surgery. Primary care constituted 41 and 29 % of the difference in direct costs in Sweden and Finland, respectively. From a societal perspective, the total economic burden of osteoarthritis is substantial, and the incremental cost was estimated to €1.1–€1.3 billion yearly for patients in specialty care across the Nordic countries. When including patients in primary care, incremental costs rose to €3 billion in Sweden and €1.8 billion in Finland. Given the large economic impact, finding cost-effective and safe therapeutic strategies for these patients will be important.

see all

Series: Scandinavian journal of pain
ISSN: 1877-8860
ISSN-E: 1877-8879
ISSN-L: 1877-8860
Volume: 23
Issue: 4
Pages: 694 - 704
DOI: 10.1515/sjpain-2023-0015
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This study was sponsored by Pfizer and Eli Lilly & Company.
Copyright information: © 2022 Walter de Gruyter GmbH, Berlin/Boston.