Knee pain as a reason for down economy
Today if you tune into any news channels, you’ll see people debating (even shouting) about how the Indian economy is growing too slowly, what steps the government should take, and why there’s a need to bring reforms – the list is neverending. While there’s a genuine need to discuss such issues, every single media agency missed out on one silent parasite affecting the Indian economy – physical disability. With around 15 crore Indians suffering from knee pain alone, incidents of knee arthritis are about 15 times higher than in most Western nations. Even though India’s disability frequency is lower than western nations (2% vs 15%), the probable inaccuracy and the sheer size of our population make it far more challenging to face. If this didn’t alarm you enough, the majority of the affected belong to the age group of 40 and above (39%). Meaning, it’s India’s experienced professionals who are hurting. Knee pain is one of the most common ailments faced by Indians, with the severity of certain cases being extreme. Despite the introduction of the Ayushman Bharat campaign and the 70% price slash on implants set by the National Pharmaceutical Pricing Authority (NPPA) in 2017, the cost remains heavy for the Indian middle class. A single knee implant surgery ranges from Rs. 1.5 – 3.8 lakhs, an amount well beyond the average Indian’s ability to spend. While the direct costs amount to most of a patient’s bill (about 56%), a significant cost comes through indirect costs. This includes caretaker costs, psychological therapy costs (in case of worsening mental state which is common amongst such patients), rehabilitation costs, etc. A report in 2018 concluded that the average total cost of recovery without surgery is around Rs. 9,000, compared to Rs. 12,000 in direct costs.

Although studies suggest that about 4 crore Indians need total knee replacement surgeries, roughly only 1.5 lakh knee surgeries are actually performed annually in India.

The government’s price cap also drives away foreign manufacturers, who are hesitant to introduce their latest and best implants in India. Despite having one of the largest medical consumer bases in the world, not getting manufacturers to invest in the country has adverse effects on the national economy, especially when India hopes to ramp up its medical tourism. Knee osteoarthritis is expected to be India’s fourth biggest physical disability problem in the next decade. That is particularly because of India’s growing elderly population, which could be around 20% of India’s population by 2050. Since the prevalence of knee problems jumps to around 80% amongst the elderly population, the rise in problems seems inevitable. No matter the scale of the issue, any measure to minimize the effect must begin with physiotherapy clinics. The need to use affordable, ingenious technology to lower the costs of tests like GAIT Analysis should be a priority. Another useful suggestion would be increased quantification of data to introduce patient customization. Improving efficiency of treatment and greater patient adherence results in lower costs and lesser traffic in clinics. The increase in data also helps draw key points of understanding of certain patterns that may be observed with patients regarding common issues, paving the way for new, interesting research to be done. While India will continue to bear the pain of its economy, the necessity to acknowledge and reduce the scale of such a problem is important. An improved environment where hurting people can get themselves treated is a blessing for everyone. It helps investors think better about the country as well as enables its citizens to feel hopeful and drives up the country’s productivity. This way, an inevitable dent can be vastly minimized, allowing India to focus on other aspects of its growth as it aims to make its way into the list of developed nations – one for the world to emulate and another for its patient citizens. References:
  1. https://pib.gov.in/newsite/PrintRelease.aspx?relid=170040#:~:text=Based%20on%20the%20numbers%20of,a%20saving%20of%20about%20Rs.
  2. https://jyoungpharm.org/sites/default/files/JYoungPharm_10_3_322.pdf
  3. https://timesofindia.indiatimes.com/readersblog/arthritis-care-foundation/why-the-incidence-of-arthritis-is-on-the-rise-in-india-5191/
  4. https://timesofindia.indiatimes.com/readersblog/arthritis-care-foundation/india-facing-knee-arthritis-epidemic-6156/
  5. https://www.researchgate.net/publication/263579957_The_Economic_Burden_of_Disability_in_India_Estimates_from_the_NSS_Data
  6. https://www.ilo.org/wcmsp5/groups/public/—asia/—ro-bangkok/—sro-new_delhi/documents/publication/wcms_229259.pdf
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3893941/
  8. file:///C:/Users/sgogo/Downloads/clinpract-12-00026.pdf
  9. https://pubmed.ncbi.nlm.nih.gov/19817509/
  10. www.researchgate.net/publication/344809810_Burden_of_Osteoarthritis_in_India 
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132764/
  12. https://timesofindia.indiatimes.com/india/government-caps-price-of-knee-implants-surgeries-to-cost-nearly-70-less/articleshow/60089265.cms
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