PMD71 The Switch Study: The Impact of Continuous Glucose Monitoring on Health Care Resource Utilization

Abstract

OBJECTIVES:To analyze the cost effectiveness of patelet rich plasma versus corticosteroids in the treatment of lateral epicondylitis in a Norwegian setting. METHODS: A probabilistic Markov model was developed in Microsoft Excel, based on clinical data from two papers reporting results from a randomized double blind clinical trial comparing the effect of platelet rich plasma (L-PRP,nϭ49) to corticosteroids (CCS, nϭ51) as treatment of lateral epicondylitis (Peerbooms et al 2010, Gosens et al 2011. The primary outcome of these papers, were Disability of Arm, Shoulder and Hand (DASH) and the Numerical Pain Visual Analogue Scale (NPRS-VAS). The study which was conducted in The Netherlands, showed statistically significant differences on the visual analogue scale and the DASH in favor of L-PRP after 6, 12 and 24 months. In order to make a cost utility analysis, the VAS-scores were mapped to EQ-5D, using the method suggested in Dixon et al 2011. In this study the derived utility values for a series of EQ-5D health states replaced the pain value with the NPRSVAS, thereby allowing a greater range of pain intensities to be captured and included in economic analyses. This raises an issue regarding transferability of QALY-values. Nord E. 1991 concludes that QALY-values elicited in Norway, The Netherlands, England or Sweden can be used for medical decision making purposes in any of the other three countries. RESULTS: The results show an incremental cost effectiveness ratio of € 5 000 per QALY. This is well within what is considered cost effective in Norway. The probabilistic analysis demonstrates that the probability of L-PRP being the cost effective alternative is as high as 99% even when the willingness to pay for additional QALY is as low as € 13 000. CONCLUSIONS: Compared to corticosteroids, treating lateral epicondylitis with L-PRP represents the cost effective treatment strategy in Norway.