51. Cost–Effectiveness of Interventions for Musculoskeletal Conditions


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Richard Lord, www.rlordphoto.com

Musculoskeletal conditions are the most common cause of chronic disability globally and are expected to become increasingly prevalent in aging populations. Estimates of the global burden of these conditions have increased 25 percent in the last decade. Musculoskeletal conditions account for 3.4 percent of the total burden of disease in the developed world, compared with 1.7 percent in the developing world.

Musculoskeletal conditions include osteoarthritis, inflammatory arthritis, rheumatoid arthritis and seronegative spondyloarthropathies, back pain, musculoskeletal injuries, crystal arthritis, and osteoporosis (OP) and other metabolic bone diseases.

In many cases, musculoskeletal conditions are preventable with simple interventions such as maintaining ideal body weight and exercising. However, the field of study is hampered by a lack of epidemiological and outcome data across a broad spectrum of geography, conditions, and treatments. Medications such as analgesic and anti–inflammatory drugs for arthritis and pain, and vitamin D and calcium supplementation to prevent OP, should be made widely available. Treatment of inflammatory forms of arthritis with biologic agents, an area of exciting medical advances, is not currently cost–effective in developing countries. Access to hip and knee replacements, probably the most cost–effective surgical intervention available, depends on the availability of qualified staff.

Because musculoskeletal diseases are not fatal, they lack the high profile of other conditions. As issues related to communicable diseases are resolved worldwide, the hope is that more resources will become available for tackling the burgeoning epidemic of noncommunicable disease, including musculoskeletal conditions.