Cost‐Effectiveness of Diet and Exercise for Overweight and Obese Patients With Knee Osteoarthritis

Jul 29, 2018Arthritis care & research

Cost-Effectiveness of Diet and Exercise for Overweight and Obese People with Knee Joint Osteoarthritis

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Abstract

An intensive diet and exercise program resulted in a mean weight reduction of 10.6 kg and a 51% pain reduction in knee osteoarthritis patients.

The diet and exercise program led to a gain of 0.054 quality-adjusted life-years (QALYs) per person.
From the health care sector perspective, the program cost $1,845, while from the societal perspective, it cost $1,624.
The incremental cost-effectiveness ratios (ICERs) were $34,100 per QALY from the health care sector perspective and $30,000 per QALY from the societal perspective.
Probabilistic sensitivity analyses indicated a 58% and 100% likelihood of the program being cost-effective at $50,000/QALY and $100,000/QALY thresholds, respectively.

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OBJECTIVE: The Intensive Diet and Exercise for Arthritis (IDEA) trial showed that an intensive diet and exercise (D+E) program led to a mean 10.6-kg weight reduction and 51% pain reduction in patients with knee osteoarthritis (OA). The aim of the current study was to investigate the cost-effectiveness of adding this D+E program to treatment in overweight and obese (body mass index >27 kg/m) patients with knee OA. 2

METHODS: We used the Osteoarthritis Policy Model to estimate quality-adjusted life-years (QALYs) and lifetime costs for overweight and obese patients with knee OA, with and without the D+E program. We evaluated cost-effectiveness with the incremental cost-effectiveness ratio (ICER), a ratio of the differences in lifetime cost and QALYs between treatment strategies. We considered 3 cost-effectiveness thresholds: $50,000/QALY, $100,000/QALY, and $200,000/QALY. Analyses were conducted from health care sector and societal perspectives and used a lifetime horizon. Costs and QALYs were discounted at 3% per year. D+E characteristics were derived from the IDEA trial. Deterministic and probabilistic sensitivity analyses (PSAs) were used to evaluate parameter uncertainty and the effect of extending the duration of the D+E program.

RESULTS: In the base case, D+E led to 0.054 QALYs gained per person and cost $1,845 from the health care sector perspective and $1,624 from the societal perspective. This resulted in ICERs of $34,100/QALY and $30,000/QALY. In the health care sector perspective PSA, D+E had 58% and 100% likelihoods of being cost-effective with thresholds of $50,000/QALY and $100,000/QALY, respectively.

CONCLUSION: Adding D+E to usual care for overweight and obese patients with knee OA is cost-effective and should be implemented in clinical practice.

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Cost‐Effectiveness of Diet and Exercise for Overweight and Obese Patients With Knee Osteoarthritis

Abstract

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