Cost of Musculoskeletal Conditions Surprisingly High

Alice Goodman

June 18, 2014

PARIS — Musculoskeletal conditions are associated with higher healthcare costs, compared with other diseases, a new study shows.

In fact, costs were higher for people with musculoskeletal conditions, whether or not they had any comorbid conditions.

"Policy makers should pay attention to these findings by prioritizing musculoskeletal conditions in their healthcare budgets," said Antje van der Zee-Neuen, MD, from the division of rheumatology at Maastricht University in the Netherlands.

Experts say that these results are generalizable to Europe, the United States, and other western countries.

In Europe, 70% to 80% of all healthcare costs are related to chronic diseases. A large proportion of that is related to musculoskeletal conditions, which encompass more than 150 muscle, bone, and joint problems.

Dr. van der Zee-Neuen presented the study results here at the European League Against Rheumatism (EULAR) Congress 2014.

The researchers looked at the results of a cross-sectional household survey, which was completed by 8904 randomly selected Dutch people older than 18 years. Survey participants reported on sociodemographic and lifestyle factors, physician-diagnosed diseases, and healthcare costs incurred during the previous 3 months.

Of the people surveyed, 8.5% reported having only a musculoskeletal condition, 6.1% had a musculoskeletal condition as 1 of 2 comorbid conditions, and 5.6% had a musculoskeletal condition and at least 2 other conditions.

For people with only 1 condition, costs were higher for those with a musculoskeletal condition than for those with any other single chronic condition assessed (cancer, migraine, and respiratory, skin, mental, and bowel conditions). Each added disease steeply increased costs, and costs were highest when a musculoskeletal condition was present.

"Costs for an individual with 2 conditions — neither of which was a musculoskeletal condition — were twice as high as costs for a healthy person. But if 1 of the individual's 2 diseases was musculoskeletal, healthcare costs were 3 times higher," Dr. van der Zee-Neuen reported.

"It is clear that the cost of delivering care to patients with musculoskeletal conditions is considerably higher than for those with other diseases," she explained.

The researchers used the Dutch manual for pharmaco-economic healthcare evaluations 2010 (adjusted for inflation) to calculate costs.

For a healthy person, average healthcare cost for 3 months was estimated to be €170 (US$230).

Table. Estimated 3-Month Healthcare Cost per Person

Total Number of Conditions Men, € (US$) Women, € (US$)
Including musculoskeletal    
   1 328 (444) 483 (654)
   2 483 (654) 711 (963)
Not including musculoskeletal    
   1 220 (298) 323 (437)
   2 355 (481) 522 (707)


Dr. van der Zee-Neuen explained that musculoskeletal conditions should be brought to the attention of other specialists who treat comorbid diseases. "We need to make these physicians aware of the high cost of musculoskeletal conditions and that management requires multidisciplinary collaboration."

"I think these results can be transposed to the United States, as well as Europe," said EULAR president Gerd Burmester, MD, from the Charité-Universitätsmedizin in Berlin, Germany.

"Society doesn't realize how important and how costly musculoskeletal conditions are, both the direct and indirect costs," he explained. There is much more awareness of the high costs of heart disease and mental illness.

"If you have no mobility, it is a nightmare. You can't work," he told Medscape Medical News. "People with heart disease are not out of work."

"This study suggests that we need to reduce the high costs of these diseases," Dr. Burmester said.

Dr. van der Zee-Neuen has disclosed no relevant financial relationships. Dr. Burmester reports financial relationships with BMS, AbbVie, Pfizer, MedImmune, MSD, Novartis, Roche, UCB, and Lilly.

European League Against Rheumatism (EULAR) Congress 2014: Abstract OP0197. Presented June 12, 2014.


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