supplements sold in the United States are for equine
consumption, and 49% of all horse owners purchase
and administer some sort of dietary supplement to
their horses. In a study of feeding practices in
3-day event horses, the authors found that horses
were supplemented with an average of four different
oral products daily, including electrolytes, plain salt,
and OJHSs.
14
Given the high prevalence of OA and horse own-
ers’ documented willingness to purchase OJHSs, the
purpose of this review is to relay pertinent informa-
tion regarding the economic impact of OA and nu-
tritional supplements marketed to support joint
health (i.e., OJHSs). The information in this
manuscript is anticipated to benet equine practi-
tioners by providing the necessary tools to select and
market quality OJHSs to clients with either OA-
affected horses or those at-risk for developing OA.
This will not only improve the quality of life of our
client’s horses but also improve protability for vet-
erinary practices.
2. The Economic Impact of OA
In human medicine, OA is a leading cause of mor-
bidity and one of the top 10 causes of disability
worldwide.
15,16 The economic impact of OA has
been assessed in various studies. In 2005, a Cana-
dian group assessed both direct and indirect costs
attributable to OA.
15 Direct costs are those paid to
the health-care system and out-of-pocket expendi-
tures paid by the patient for prescriptions, medical
devices, transportation, and home adaptations.
Indirect costs include lost income or leisure time by
the patient because of disease and informal care
provided by unpaid caregivers for such activities as
assistance with personal care and household and
yard chores.
Of the 1,378 patients included in the study, the
average annual cost per patient was approximately
$10,000 (U.S. dollars). One-fth of these costs were
attributable to direct costs, whereas the remaining80% of OA-related costs were indirect. Indirect
costs related to OA are, therefore, important and as
pointed out by the study authors, must be consid-
ered, because failure to incorporate caregiver costs
“undervalues the cost of illness.”
15
In equine practice, the direct costs of OA include
diagnostic and treatment fees charged by veterinar-
ians. Indirect costs include loss of employed or lei-
sure time spent caring for the horse by the owner (or
primary caregiver), loss of income of a performance
horse when incapable of performance because of OA,
and increased work by the owner to care for their
horse with OA. If veterinary medicine is similar to
human medicine, then the true costs of OA, includ-
ing both direct and indirect costs, in equine practice
can be estimated. For example, if a veterinarian
examines a horse for mild to moderate persistent
lameness ($50), radiographs two joints ($250), and
treats with intra-articular medication ($250), the
direct medical costs are approximately $550 (costs
estimated usingVeterinary Fee Reference
17).
Additional direct medical costs could include NSAID
administration ($20 for an IV dose and $2.50/day for
oral administration) and the owner administering
an OJHS ($2.00/day). In 1 yr, the direct medical
costs could amount to approximately $3,000. If one
considers indirect medical expenses, the cost of this
horse could be substantially higher—perhaps as
high as $15,000/yr.
3. The Nutritional-Supplement Industry
The veterinary nutritional-supplement industry has
grown almost exponentially over the past decade,
and market surveys suggest that it will continue to
do so until at least 2012. Total retail sales of vet-
erinary nutritional supplements in 2007 exceeded
1.2 billion U.S. dollars and are anticipated to reach
almost 2 billion U.S. dollars over the next few years
(Fig. 2).
13
At present, equine veterinarians benet little
from this windfall, because only 11% of equine di-
etary supplements are purchased from veterinari-
ans. Instead, most equine supplements are
purchased from tack shops/saddleries (32%), online
34%
15%
10% 10% 8%5%16%
2%
Joint
Digestion
Hoof
General
vitamin/mineral
Skin/c o at
Relaxation
Co ugh/alle rgy
Other
Fig. 1. Equine nutritional supplement sales in the United
States based on function. 13
600 800 1000 1200 1400 1600 1800
U.S. Dollars
(Millions)
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Fig. 2. Actual (2003–2007) and anticipated (2008 –2012) sales of
pet supplements in the United States. 13
AAEP PROCEEDINGSVol. 562010 13
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