Cost-Utility and Cost-Effectiveness Analyses of Face-to-Face Versus Telephone-Based Nonpharmacologic Multidisciplinary Treatments for Patients With Generalized Osteoarthritis

Nienke Cuperus*, Wilbert B. van den Hout, Thomas J. Hoogeboom, Frank H. J. van den Hoogen, Thea P. M. Vliet Vlieland, Cornelia H. M. van den Ende

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective
To evaluate, from a societal perspective, the cost utility and cost effectiveness of a nonpharmacologic face‐to‐face treatment program compared with a telephone‐based treatment program for patients with generalized osteoarthritis (GOA).

Methods
An economic evaluation was carried out alongside a randomized clinical trial involving 147 patients with GOA. Program costs were estimated from time registrations. One‐year medical and nonmedical costs were estimated using cost questionnaires. Quality‐adjusted life years (QALYs) were estimated using the EuroQol (EQ) classification system, EQ rating scale, and the Short Form 6D (SF‐6D). Daily function was measured using the Health Assessment Questionnaire (HAQ) disability index (DI). Cost and QALY/effect differences were analyzed using multilevel regression analysis and cost‐effectiveness acceptability curves.

Results
Medical costs of the face‐to‐face treatment and telephone‐based treatment were estimated at €387 and €252, respectively. The difference in total societal costs was nonsignificantly in favor of the face‐to‐face program (difference €708; 95% confidence interval [95% CI] −€5,058, €3,642). QALYs were similar for both groups according to the EQ, but were significantly in favor of the face‐to‐face group, according to the SF‐6D (difference 0.022 [95% CI 0.000, 0.045]). Daily function was similar according to the HAQ DI. Since both societal costs and QALYs/effects were in favor of the face‐to‐face program, the economic assessment favored this program, regardless of society's willingness to pay. There was a 65–90% chance that the face‐to‐face program had better cost utility and a 60–70% chance of being cost effective.

Conclusion
This economic evaluation from a societal perspective showed that a nonpharmacologic, face‐to‐face treatment program for patients with GOA was likely to be cost effective, relative to a telephone‐based program.
Original languageEnglish
Pages (from-to)502-510
Number of pages9
JournalArthritis Care & Research
Volume68
Issue number4
DOIs
Publication statusPublished - Apr 2016

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