Oppong, R, Jowett, S, Lewis, M, Clarkson, K, Paskins, Z, Croft, P, Edwards, JJ, Healey, E, Jordan, KP, Morden, A, Ong, BN, Porcheret, M, Finney, A, Hay, E and Dziedzic, K (2018) Cost-effectiveness of a model consultation to support self-management in patients with osteoarthritis. Rheumatology, 57 (6). pp. 1056-1063. ISSN 1462-0332

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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.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via Oxford University Press at http://doi.org/10.1093/rheumatology/key037 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: primary care, cost-effectiveness, NICE osteoarthritis guidelines, ICECAP, EQ-5D, implementation
Subjects: R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Related URLs:
Depositing User: Symplectic
Date Deposited: 03 Apr 2018 09:00
Last Modified: 11 Jun 2018 09:39
URI: http://eprints.keele.ac.uk/id/eprint/4687

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