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

Abstract

Objective. To evaluate, from a societal perspective, the cost utility and cost effectiveness of a nonpharmacologic faceto-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 e387 and e252, respectively. The difference in total societal costs was nonsignificantly in favor of the face-to-face program (difference e708; 95% confidence interval [95% CI] 2e5,058, e3,642). 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 faceto-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.

Economic evaluation of telephone-based weight loss support for patients with knee osteoarthritis: a randomised controlled trial

“…To our knowledge, there are no other economic evaluations of telephone-based interventions for patients with knee osteoarthritis, hampering comparisons to similar interventions. A recent study assessed the cost-effectiveness of a 6-week multidisciplinary face-to-face treatment program compared with a telephone-based program for patients with osteoarthritis [38]. In this study, all patients received in-depth education about osteoarthritis, pain management, physical activity and diet, with the overall goal to enhance self-management skills [38].…”

“…A recent study assessed the cost-effectiveness of a 6-week multidisciplinary face-to-face treatment program compared with a telephone-based program for patients with osteoarthritis [38]. In this study, all patients received in-depth education about osteoarthritis, pain management, physical activity and diet, with the overall goal to enhance self-management skills [38]. Patients in the face-to-face group received six therapeutic groups session (2–4 h each), whereas the telephone group received only two face-to-face group sessions (2–2.5 h each) and four individual telephone contacts (15–30 min each).…”

Cost-effectiveness of telephone-based weight loss support for patients with knee osteoarthritis: a pragmatic randomised controlled trial

“…The study found that from a societal perspective the face-to-face treatment was more likely to be cost-effective at 1-year follow-up. 38 These results, together with the findings from our current study, suggest that telephone-based care for patients with osteoarthritis may not be a cost-effective management approach. Since many patients with osteoarthritis do not receive recommended treatments via clinical models of care, 13,39 understanding why telephone-based interventions are reported to be as effective as face-to-face interventions but not cost-effective, is an important consideration to inform how best to provide care to this patient group.…”

“…A more recent high-quality study assessed the cost-effectiveness of a 6-week multidisciplinary face-to-face treatment program compared with a telephone-based program for patients with generalised osteoarthritis. 38 In this study, all patients received in-depth education with the overall goal to enhance self-management skills. 38 Patients in the face-toface group received six therapeutic groups session (2-4 hours each), whereas the telephone group received only two face-to-face group sessions (2-2.5 hours each) and four individual telephone contacts (15-30 mins each).…”

“…38 In this study, all patients received in-depth education with the overall goal to enhance self-management skills. 38 Patients in the face-toface group received six therapeutic groups session (2-4 hours each), whereas the telephone group received only two face-to-face group sessions (2-2.5 hours each) and four individual telephone contacts (15-30 mins each). The study found that from a societal perspective the face-to-face treatment was more likely to be cost-effective at 1-year follow-up.…”