RT Journal Article
SR Electronic
T1 Cost-effectiveness of treatment strategies for osteoarthritis of the knee in Taiwan.
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1797
OP 1803
VO 31
IS 9
A1 Zui-Shen Yen
A1 Mei-Shu Lai
A1 Chen-Ti Wang
A1 Li-Shu Chen
A1 Shyr-Chyr Chen
A1 Wen-Jone Chen
A1 Sheng-Mou Hou
YR 2004
UL http://www.jrheum.org/content/31/9/1797.abstract
AB OBJECTIVE: To evaluate the cost-effectiveness of 3 treatment strategies for osteoarthritis (OA) of the knee: naproxen, celecoxib, and hyaluronan. METHODS: We developed a decision model to estimate the costs and effectiveness of 3 treatment strategies: 250 mg naproxen 3 times daily for 26 weeks, 100 mg celecoxib twice daily for 26 weeks, and 25 mg hyaluronan by intraarticular injection once per week for 5 weeks followed by conventional treatment for 21 weeks. The probabilities and utility data were obtained by surveying the literature and consulting experts. Cost data were obtained from insurance reimbursement data of National Taiwan University Hospital and were converted to 2002 US dollars. The timeframe of the decision tree was 26 weeks. Outcomes were expressed in aggregated costs, quality-adjusted life-years (QALY), and the incremental cost-effectiveness ratio (ICER). Sensitivity analyses were performed on most variables. RESULTS: The expected total costs for the naproxen, celecoxib, and hyaluronan strategies were US$498.98, US$547.80, and US$678.00, respectively. The ICER of the celecoxib strategy compared with the naproxen strategy was US$21,226 per QALY gained. The ICER of the hyaluronan strategy versus the celecoxib strategy was US$42,000 per QALY gained. The ICER of the hyaluronan strategy decreased to about US$25,000 per QALY gained if the weekly treatment cost of hyaluronan was decreased to US$31. CONCLUSION: Celecoxib treatment results in a reasonable cost-effectiveness ratio for patients with OA of the knee. Hyaluronan treatment, however, may not be an economically attractive choice under the current healthcare scenario in Taiwan.