Cost Effectiveness of Pharmacological Management for Osteoarthritis: A Systematic Review.

Shi, J; Fan, K; Yan, L; Fan, Z; Li, F; Wang, G; Liu, H; Liu, P; Yu, H; Li, JJ; Wang, B

Cost Effectiveness of Pharmacological Management for Osteoarthritis: A Systematic Review.

Shi, J Fan, K Yan, L Fan, Z Li, F Wang, G Liu, H Liu, P Yu, H Li, JJ Wang, B

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Publisher:: SPRINGER INT PUBL AG
Publication Type:: Journal Article
Citation:: Appl Health Econ Health Policy, 2022, 20, (3), pp. 351-370
Issue Date:: 2022-05

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Field	Value	Language
dc.contributor.author	Shi, J
dc.contributor.author	Fan, K
dc.contributor.author	Yan, L
dc.contributor.author	Fan, Z
dc.contributor.author	Li, F
dc.contributor.author	Wang, G
dc.contributor.author	Liu, H
dc.contributor.author	Liu, P
dc.contributor.author	Yu, H
dc.contributor.author	Li, JJ
dc.contributor.author	Wang, B
dc.date.accessioned	2023-01-18T05:28:05Z
dc.date.available	2022-01-16
dc.date.available	2023-01-18T05:28:05Z
dc.date.issued	2022-05
dc.identifier.citation	Appl Health Econ Health Policy, 2022, 20, (3), pp. 351-370
dc.identifier.issn	1175-5652
dc.identifier.issn	1179-1896
dc.identifier.uri	http://hdl.handle.net/10453/165135
dc.description.abstract	BACKGROUND AND OBJECTIVE: Osteoarthritis (OA) is a highly prevalent, disabling disease requiring chronic management that is associated with an enormous individual and societal burden. This systematic review provides a global cost-effectiveness evaluation of pharmacological therapy for the management of OA. METHODS: Following Center for Reviews and Dissemination (CRD) guidance, a literature search strategy was undertaken using PubMed, EMBASE, Cochrane Library, Health Technology Assessment (HTA) database, and National Health Service Economic Evaluation database (NHS EED) to identify original articles containing cost-effectiveness evaluation of OA pharmacological treatment published before 4 November 2021. Risk of bias was assessed by two independent reviewers using the Joanna Briggs Institute (JBI) critical appraisal checklist for economic evaluations. The Quality of Health Economic Studies (QHES) instrument was used to assess the reporting quality of included articles. RESULTS: Database searches identified 43 cost-effectiveness analysis studies (CEAs) on pharmacological management of OA that were conducted in 18 countries and four continents, with one study containing multiple continents. A total of four classes of drugs were assessed, including non-steroidal anti-inflammatory drugs (NSAIDs), opioid analgesics, symptomatic slow-acting drugs for osteoarthritis (SYSADOAs), and intra-articular (IA) injections. The methodological approaches of these studies showed substantial heterogeneity. The incremental cost-effectiveness ratios (ICERs) per quality-adjusted life-year (QALY) were (in 2021 US dollars) US$44.40 to US$307,013.56 for NSAIDS, US$11,984.84 to US$128,028.74 for opioids, US$10,930.17 to US$27,799.73 for SYSADOAs, and US$258.36 to US$58,447.97 for IA injections in different continents. The key drivers of cost effectiveness included medical resources, productivity, relative risks, and selected comparators. CONCLUSION: This review showed substantial heterogeneity among studies, ranging from a finding of dominance to very high ICERs, but most studies found interventions to be cost effective based on specific ICER thresholds. Important challenges in the analysis were related to the standardization and methodological quality of studies, as well as the presentation of results.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	SPRINGER INT PUBL AG
dc.relation	http://purl.org/au-research/grants/nhmrc/1120249
dc.relation.ispartof	Appl Health Econ Health Policy
dc.relation.isbasedon	10.1007/s40258-022-00717-0
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1117 Public Health and Health Services, 1402 Applied Economics, 1505 Marketing
dc.subject.classification	Health Policy & Services
dc.subject.mesh	Anti-Inflammatory Agents, Non-Steroidal
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	Humans
dc.subject.mesh	Osteoarthritis
dc.subject.mesh	Quality-Adjusted Life Years
dc.subject.mesh	State Medicine
dc.subject.mesh	Humans
dc.subject.mesh	Osteoarthritis
dc.subject.mesh	Anti-Inflammatory Agents, Non-Steroidal
dc.subject.mesh	Quality-Adjusted Life Years
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	State Medicine
dc.title	Cost Effectiveness of Pharmacological Management for Osteoarthritis: A Systematic Review.
dc.type	Journal Article
utslib.citation.volume	20
utslib.location.activity	New Zealand
utslib.for	1117 Public Health and Health Services
utslib.for	1402 Applied Economics
utslib.for	1505 Marketing
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology/School of Biomedical Engineering
utslib.copyright.status	open_access	*
dc.date.updated	2023-01-18T05:28:01Z
pubs.issue	3
pubs.publication-status	Published
pubs.volume	20
utslib.citation.issue	3

Abstract:

BACKGROUND AND OBJECTIVE: Osteoarthritis (OA) is a highly prevalent, disabling disease requiring chronic management that is associated with an enormous individual and societal burden. This systematic review provides a global cost-effectiveness evaluation of pharmacological therapy for the management of OA. METHODS: Following Center for Reviews and Dissemination (CRD) guidance, a literature search strategy was undertaken using PubMed, EMBASE, Cochrane Library, Health Technology Assessment (HTA) database, and National Health Service Economic Evaluation database (NHS EED) to identify original articles containing cost-effectiveness evaluation of OA pharmacological treatment published before 4 November 2021. Risk of bias was assessed by two independent reviewers using the Joanna Briggs Institute (JBI) critical appraisal checklist for economic evaluations. The Quality of Health Economic Studies (QHES) instrument was used to assess the reporting quality of included articles. RESULTS: Database searches identified 43 cost-effectiveness analysis studies (CEAs) on pharmacological management of OA that were conducted in 18 countries and four continents, with one study containing multiple continents. A total of four classes of drugs were assessed, including non-steroidal anti-inflammatory drugs (NSAIDs), opioid analgesics, symptomatic slow-acting drugs for osteoarthritis (SYSADOAs), and intra-articular (IA) injections. The methodological approaches of these studies showed substantial heterogeneity. The incremental cost-effectiveness ratios (ICERs) per quality-adjusted life-year (QALY) were (in 2021 US dollars) US$44.40 to US$307,013.56 for NSAIDS, US$11,984.84 to US$128,028.74 for opioids, US$10,930.17 to US$27,799.73 for SYSADOAs, and US$258.36 to US$58,447.97 for IA injections in different continents. The key drivers of cost effectiveness included medical resources, productivity, relative risks, and selected comparators. CONCLUSION: This review showed substantial heterogeneity among studies, ranging from a finding of dominance to very high ICERs, but most studies found interventions to be cost effective based on specific ICER thresholds. Important challenges in the analysis were related to the standardization and methodological quality of studies, as well as the presentation of results.

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http://hdl.handle.net/10453/165135