Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-26T06:16:39.432Z Has data issue: false hasContentIssue false
  • English
  • Français

Cost-effectiveness of a supplementary class-based exercise program in the treatment of knee osteoarthritis

Published online by Cambridge University Press:  27 February 2006

Gerry Richardson ,
Neil Hawkins ,
Christopher James McCarthy ,
Pauline Mary Mills ,
Rachel Pullen ,
Christopher Roberts ,
Alan Silman  and
Jacqueline Ann Oldham
Gerry Richardson
Affiliation:
University of York
Neil Hawkins
Affiliation:
University of York
Christopher James McCarthy
Affiliation:
University of Manchester
Pauline Mary Mills
Affiliation:
University of Manchester
Rachel Pullen
Affiliation:
University of Manchester
Christopher Roberts
Affiliation:
University of Manchester
Alan Silman
Affiliation:
University of Manchester
Jacqueline Ann Oldham
Affiliation:
University of Manchester
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: The aim of this study was to assess the cost-effectiveness of a class-based exercise program supplementing a home-based program when compared with a home-based program alone. In addition, we estimated the probability that the supplementary class program is cost-effective over a range of values of a decision maker's willingness to pay for an additional quality-adjusted life-year (QALY).

Methods: The resource use and effectiveness data were collected as part of the clinical trial detailed elsewhere. Unit costs were estimated from published sources. The net benefit approach to cost-effectiveness analysis is used to estimate the probability of the intervention being cost-effective.

Results: The addition of a supplementary class-based group results in an increase in QALYs and lower costs. For all plausible values of a decision maker's willingness to pay for a QALY, the supplementary class group is likely to be cost-effective.

Conclusions: The addition of a class-based exercise program is likely to be cost-effective and, on current evidence, should be implemented.

Keywords

Cost-effectivenessQALYOsteoarthritisExercise program
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 22 , Issue 1 , January 2006 , pp. 84 - 89
Copyright
© 2006 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Briggs A, O'Brien B. 2001 The death of cost-minimization analysis? Health Econ. 10: 179– 184.Google Scholar
CIPFA. 2001. Health services financial database. London: Chartered Institute for Public Finance accountants.
Curran D, Bacchi M, Hsu Schmitz SF. 1998 Identifying the types of missingness in quality of life data from clinical trials. Stat Med. 17: 739– 756.Google Scholar
Dolan P, Gudex C, Kind P, et al. 1995: A social tariff for EuroQOl: Results from a UK general population survey. York, UK: Centre for Health Economics. Centre for Health Economics; 138 Discussion Paper.
1990 EuroQol Group. EuroQol—a new facility for the measurement of health related quality of life. Health Policy. 19: 199– 208.
Fenwick E, Claxton K, Sculpher M, et al. Improving efficiency and relevance of health technology assessment: The role of iterative decision analytic modelling. York, UK: Centre for Health Economics; 2001: 179.
Lord J, Victor C, Littlejohns P, et al. 1999 Economic evaluation of a primary care based education programme for patients with osteoarthritis of the knee. Health Technol Assess. 3: 1– 55.Google Scholar
McCarthy CJ, Mills PM, Pullen R, et al. 2004 Supplementation of a home-based exercise programme with a class-based programme for people with osteoarthritis of the knees: A randomised controlled trial and health economic analysis. Health Technol Assess. 8: 1– 76.Google Scholar
Netten A, Curtis L. 2000. Unit costs of health and social care 2000. Kent, UK: Personal Social Services Research Unit;
O'Reilly SC, Muir KR, Doherty M. 1999 Effectiveness of home exercise on pain and disability from osteoarthritis of the knee: A randomised controlled trial. Ann Rheum Dis. 58: 15– 19.Google Scholar
Rubin DM, Stern HS, Vehovar V. 1995 Handling “don't know” survey responses: The case of Slovenian plebiscite. J Am Stat Assoc. 90: 822– 828.Google Scholar
Stinnett AA, Mullahy J. 1998 Net health benefits: A new framework for the analysis of uncertainty in cost-effectiveness analysis. Med Decis Making. 18: S68– S80.Google Scholar
Tambour M, Zethraeus N. 1998 A note on confidence intervals in cost-effectiveness analysis. Int J Technol Assess Health Care. 14: 467– 471.Google Scholar
Thomas KS, Muir KR, Doherty M, et al. 2002 Home based exercise programme for knee pain and knee osteoarthritis: Randomised controlled trial. BMJ. 325: 752– 757.Google Scholar
Van Baar ME, Dekker J, Oostendorp RA, et al. 1998 The effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: A randomized clinical trial. J Rheumatol. 25: 2432– 2439.Google Scholar