title: Economic impact of lower-limb osteoarthritis worldwide: a systematic review of cost-of-illness studies.
abstract: An overview of the economic consequences - overall costs as well as cost breakdown (direct and indirect) - of hip and knee osteoarthritis (OA) worldwide.
  
  
  
  A systematic literature search of EMBASE, MEDLINE, Scopus and Cochrane databases for articles was performed independently by two rheumatologists who used the same predefined eligible criteria. Papers without abstracts and in languages other than English or French were excluded. Extracted costs were converted to an annual cost and to 2013 euros (€) by using the Consumer Price Index of the relevant countries and the 2013 Purchasing Power Parities between these countries and the European Union average.
  
  
  
  A total of 45 abstracts were selected, and 32 articles were considered for the review. The studied populations were heterogeneous: administrative, hospital and national health survey data. Annual total costs per patient ranged from 0.7 to 12 k€, direct costs per patient from 0.5 to 10.9 k€ and indirect costs per patient from 0.2 to 12.3 k€. The weighted average annual costs per patient living with knee and hip OA were 11.1, 9.5 and 4.4 k€ for total, direct and indirect costs, respectively.
  
  
  
  This review highlights the heterogeneity of studies and lack of methodologic consensus to obtain reliable cost-of-illness estimates for lower-limb OA. However, costs induced by the disease seem substantial and deserve to be more extensively explored.
authors.affiliation: Rheumatology Department, Maison Blanche Hospital, Reims University Hospitals, Reims, F-51092, France; University of Reims Champagne-Ardenne, Faculty of Medicine, EA 3797, Reims, F-51095, France. Electronic address: jhsalmon@chu-reims.fr.
authors.forename: J H
authors.initials: JH
authors.lastname: Salmon
authors.affiliation: Rheumatology Department, CHU de Nancy, Hôpitaux de Brabois, Vandoeuvre-lès-Nancy, France; Université de Lorraine, Université Paris Descartes, Apemac, EA4360, 54000, Nancy, France; INSERM, CIC-EC 1433, 54000, Nancy, France. Electronic address: ac.rat@chu-nancy.fr.
authors.forename: A C
authors.initials: AC
authors.lastname: Rat
authors.affiliation: Rheumatology Department, Saint-Antoine Hospital, Inserm UMR S_938, Sorbonne Universités UPMC Univ Paris 06, Assistance Publique - Hôpitaux de Paris (AP-HP), DHU i2B, Paris, France. Electronic address: jeremie.sellam@sat.aphp.fr.
authors.forename: J
authors.initials: J
authors.lastname: Sellam
authors.affiliation: Rheumatology Department, Maison Blanche Hospital, Reims University Hospitals, Reims, F-51092, France. Electronic address: mmichel@chu-reims.fr.
authors.forename: M
authors.initials: M
authors.lastname: Michel
authors.affiliation: Rheumatology Department, Maison Blanche Hospital, Reims University Hospitals, Reims, F-51092, France. Electronic address: jpeschard@chu-reims.fr.
authors.forename: J P
authors.initials: JP
authors.lastname: Eschard
authors.affiliation: Université de Lorraine, Université Paris Descartes, Apemac, EA4360, 54000, Nancy, France; INSERM, CIC-EC 1433, 54000, Nancy, France. Electronic address: francis.guillemin@chu-nancy.fr.
authors.forename: F
authors.initials: F
authors.lastname: Guillemin
authors.affiliation: University of Reims Champagne-Ardenne, Faculty of Medicine, EA 3797, Reims, F-51095, France; Department of Research and Innovation, Robert Debré Hospital, Reims University Hospitals, Reims, F-51092, France. Electronic address: djolly@chu-reims.fr.
authors.forename: D
authors.initials: D
authors.lastname: Jolly
authors.affiliation: Rheumatology Department, Université Pierre et Marie Curie Curie - Paris 6, GRC08, Institut Pierre Louis de d'Epidémiologie et Santé Publique, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France. Electronic address: bruno.fautrel@psl.aphp.fr.
authors.forename: B
authors.initials: B
authors.lastname: Fautrel
mesh_terms: D017281:Cost of Illness; D006306:Health Surveys; D006801:Humans; D007719:Knee Joint; D015207:Osteoarthritis, Hip; D020370:Osteoarthritis, Knee
keywords: Health economics; Hip; Knee; Osteoarthritis; Systematic review