Full Papers
Economic evaluation of a tight-control treatment strategy using an imaging device (handscan) for monitoring joint inflammation in early rheumatoid arthritis
S.C. Nair1, P.M. Welsing2, J.W. Jacobs3, J.M. Van Laar4, W.H. Rensen5, G. Ardine De Wit6, J.W. Bijlsma7, F.P. Lafeber8
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands. s.c.nair@umcutrecht.nl
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
- Hemics, Eindhoven, The Netherlands.
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht; and Amsterdam Rheumatology and Immunology Center (ARC), AMC Amsterdam, The Netherlands.
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
CER8300
2015 Vol.33, N°6
PI 0831, PF 0838
Full Papers
Free to view
(click on article PDF icon to read the article)
PMID: 26343274 [PubMed]
Received: 19/01/2015
Accepted : 28/05/2015
In Press: 07/09/2015
Published: 15/12/2015
Abstract
OBJECTIVES:
To evaluate the cost-effectiveness of a tight-control treatment strategy using the handscan (TCHS) compared to using only clinical assessments (TC) and compared to a general non-tight-control treatment strategy (usual care; UC) in early rheumatoid arthritis (RA).
METHODS:
Data from 299 early RA patients from the CAMERA trial were used. Clinical outcomes were extrapolated to Quality Adjusted Life Years (QALYs) and costs using a Markov model. Costs and QALYs were compared between the TC and UC treatment strategy arm of the CAMERA trial and a simulated tight-control treatment strategy using the handscan (TCHS). Incremental Cost-Effectiveness Ratios (ICERs) were calculated and several scenario analyses performed. All analyses were performed probabilistically to obtain confidence intervals and costs-effectiveness planes and acceptability curves.
RESULTS:
In TCHS, €4,660 (95% CI -€11,516 to €2,045) was saved and 0.06 (95% CI 0.01 to 0.11) QALYs were gained when compared to UC, with an ICER of €77,670 saved per QALY gained. Ninety-one percent (91%) of simulations resulted in less costs and more QALYs. TCHS resulted in comparable costs or even limited savings €642 (95% CI -€6,903 to €5,601)) and comparable QALYs to TC. In all scenario analyses, TCHS and TC were found to be cost effective as compared to UC.
CONCLUSIONS:
A tight-control treatment strategy is highly cost-effective compared to a non-tight-control approach in early RA. Using the handscan as a monitoring device might facilitate implementation of tight-control treatment strategy at comparable costs and with comparable effects. This approach should be investigated further.
