Study Shows a High Cost for Opioid Use Among Patients with Knee OA

    Although guidelines do not recommend use of opioids to manage pain for individuals with knee osteoarthritis (OA), a recent study published online ahead of print by Arthritis Care & Research 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, from Brigham and Women’s Hospital in Boston, used a computer simulation to estimate the annual and lifetime contribution of opioids to knee OA-related costs.

    They showed that the direct medical cost of knee OA treatment including opioids totals $7.45 billion, or 53% of the total lifetime costs. The remaining 47% 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 OA, and costs associated with diversion activities related to illicit use by others.

    For an individual patient who used opioids to treat their knee OA, 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,” Dr. Losina said.

    The results reveal a substantial economic burden of opioid use among patients with knee OA, 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,” Dr. Losina said.

    “These data offer new evidence of the magnitude of the societal burden generated by opioid use and misuse and could be used to educate healthcare providers and health policy decision makers on the best alternatives to opiate use.”


    Huizinga JL, Stanley EE, Sullivan JK, et al. Societal cost of opioid use in symptomatic knee osteoarthritis patients in the United States. Arthritis Care Res (Hoboken). 2021 Feb 24. doi: 10.1002/acr.24581. Online ahead of print.