Raymond Oppong
Cost-effectiveness of a model consultation to support self-management in patients with osteoarthritis
Oppong, Raymond; Jowett, Sue; Lewis, Martyn; Clarkson, Kris; Paskins, Zoe; Croft, Peter; Edwards, John J; Healey, Emma; Jordan, Kelvin P; Morden, Andrew; Ong, Bie Nio; Porcheret, Mark; Finney, Andrew; Hay, Elaine; Dziedzic, Krysia
Authors
Sue Jowett
Alyn Lewis a.m.lewis@keele.ac.uk
Kris Clarkson
Zoe Paskins z.paskins@keele.ac.uk
Peter Croft
John J Edwards
Emma Healey e.healey@keele.ac.uk
Kelvin Jordan k.p.jordan@keele.ac.uk
Andrew Morden
Bie Nio Ong
Mark Porcheret
Andrew Finney a.finney@keele.ac.uk
Elaine Hay e.m.hay@keele.ac.uk
Professor Krysia Dziedzic k.s.dziedzic@keele.ac.uk
Abstract
Objectives: The aim of this study was to estimate the cost-effectiveness of a model OA consultation for OA to support self-management compared with usual care. Methods: An incremental cost-utility analysis using patient responses to the three-level EuroQoL-5D (EQ-5D) questionnaire was undertaken from a UK National Health Service perspective alongside a two-arm cluster-randomized controlled trial. Uncertainty was explored through the use of cost-effectiveness acceptability curves. Results: Differences in health outcomes between the model OA consultation and usual care arms were not statistically significant. On average, visits to the orthopaedic surgeon were lower in the model OA consultation arm by -0.28 (95% CI: -0.55, -0.06). The cost-utility analysis indicated that the model OA consultation was associated with a non-significant incremental cost of £-13.11 (95% CI: -81.09 to 54.85) and an incremental quality adjusted life year (QALY) of -0.003 (95% CI: -0.03 to 0.02), with a 44% chance of being cost-effective at a threshold of £20 000 per QALY gained. The percentage of participants who took time off and the associated productivity cost were lower in the model OA consultation arm. Conclusion: Implementing National Institute for Health and Care Excellence guidelines using a model OA consultation in primary care does not appear to lead to increased costs, but health outcomes remain very similar to usual care. Even though the intervention seems to reduce the demand for orthopaedic surgery, overall it is unlikely to be cost-effective.
Citation
Oppong, R., Jowett, S., Lewis, M., Clarkson, K., Paskins, Z., Croft, P., …Dziedzic, K. (2018). Cost-effectiveness of a model consultation to support self-management in patients with osteoarthritis. Rheumatology, 57(6), 1056-1063. https://doi.org/10.1093/rheumatology/key037
Journal Article Type | Article |
---|---|
Acceptance Date | Jan 30, 2018 |
Online Publication Date | Mar 14, 2018 |
Publication Date | 2018-06 |
Journal | Rheumatology |
Print ISSN | 1462-0324 |
Publisher | Oxford University Press |
Peer Reviewed | Peer Reviewed |
Volume | 57 |
Issue | 6 |
Pages | 1056-1063 |
DOI | https://doi.org/10.1093/rheumatology/key037 |
Keywords | primary care, cost-effectiveness, NICE osteoarthritis guidelines, ICECAP, EQ-5D, implementation |
Publisher URL | http://doi.org/10.1093/rheumatology/key037 |
Files
key037.pdf
(175 Kb)
PDF
Publisher Licence URL
https://creativecommons.org/licenses/by-nc/4.0/
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