Qiu Kaijie, Wang Canlong, Mo Xianan, Yang Guang, Huang Lu, Wu Yan, Pan Zongyou
Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Orthopedics Research Institute of Zhejiang University, Hangzhou City, Zhejiang Province, PR China.
Int J Surg. 2025 Jul 22. doi: 10.1097/JS9.0000000000003072.
Previous literature lacks comprehensive reporting on the economic burden of musculoskeletal disorders (MSDs). Our objective was to report the macroeconomic burden of MSDs, and their subcategories, including rheumatoid arthritis, osteoarthritis, low back pain, neck pain, gout, and other musculoskeletal disorders, across 183 countries and regions in 2021.
Data on overall MSDs and their subcategories in disability-adjusted life years (DALYs) were collected from the Global Burden of Disease (GBD) 2019 and 2021 database. Purchasing power parity (PPP)-adjusted gross domestic product (GDP) data were obtained from the World Bank. GDP and DALY data were combined, and the value of lost welfare (VLW) method was used to estimate macroeconomic losses. All results are presented in 2021 international dollars (PPP-adjusted).
In 2021, MSDs were responsible for a global VLW of $2099.84 billion, representing 1.41% of global GDP. Among MSD subcategories, low back pain had the highest VLW/GDP ratio (43%), followed by other musculoskeletal disorders (27%) and osteoarthritis (14%). The highest economic burden was observed in high-income regions (1.74% of GDP), while the lowest was in sub-Saharan Africa (0.65% of GDP). At the national level, Cyprus and Japan experienced losses exceeding 2% of GDP. Age- and sex-specific analyses further showed that the highest burden occurred among people aged 55-59 years, with females generally bearing greater costs than males, except in gout.
MSDs impose a substantial economic burden on the global economy, especially in high-income regions. Moreover, it is anticipated that lower- and middle-income regions will also face significant economic impacts from MSDs in the future. Among the subcategories, low back pain and other musculoskeletal disorders contribute the most to the overall disease burden. High-income regions should prioritize cost-effective care pathways, early intervention, and access to quality rehabilitation services, while lower- and middle-income regions need to strengthen MSDs prevention and invest in healthcare infrastructure to better manage the growing burden.
以往文献对肌肉骨骼疾病（MSD）的经济负担缺乏全面报道。我们的目标是报告2021年183个国家和地区MSD及其子类别（包括类风湿性关节炎、骨关节炎、腰痛、颈痛、痛风和其他肌肉骨骼疾病）的宏观经济负担。
从全球疾病负担（GBD）2019和2021数据库收集了残疾调整生命年（DALY）中MSD及其子类别的数据。购买力平价（PPP）调整后的国内生产总值（GDP）数据来自世界银行。将GDP和DALY数据相结合，并使用福利损失价值（VLW）方法来估计宏观经济损失。所有结果均以2021年国际美元（PPP调整后）呈现。
2021年，MSD造成的全球福利损失价值为2.09984万亿美元，占全球GDP的1.41%。在MSD子类别中，腰痛的VLW/GDP比率最高（43%），其次是其他肌肉骨骼疾病（27%）和骨关节炎（14%）。在高收入地区观察到最高的经济负担（占GDP的1.74%），而在撒哈拉以南非洲最低（占GDP的0.65%）。在国家层面，塞浦路斯和日本的损失超过GDP的2%。按年龄和性别进行的分析进一步表明，最高负担出现在55 - 59岁的人群中，除痛风外，女性通常比男性承担更高的成本。
MSD给全球经济带来了巨大的经济负担，尤其是在高收入地区。此外，预计未来低收入和中等收入地区也将面临MSD带来的重大经济影响。在子类别中，腰痛和其他肌肉骨骼疾病对总体疾病负担的贡献最大。高收入地区应优先考虑具有成本效益的护理途径、早期干预和获得优质康复服务的机会，而低收入和中等收入地区需要加强MSD预防并投资于医疗基础设施，以更好地应对不断增加的负担。
