Glucosamine sulphate in the treatment of knee osteoarthritis: cost-effectiveness comparison with paracetamol.
BACKGROUND
The aim of this study was to explore the cost-effectiveness of glucosamine sulphate (GS) compared with paracetamol and placebo (PBO) in the treatment of knee osteoarthritis. For this purpose, a 6-month time horizon and a health care perspective was used.


METHODS
The cost and effectiveness data were derived from Western Ontario and McMaster Universities Osteoarthritis Index data of the Glucosamine Unum In Die (once-a-day) Efficacy trial study by Herrero-Beaumont et al. Clinical effectiveness was converted into utility scores to allow for the computation of cost per quality-adjusted life year (QALY) For the three treatment arms Incremental Cost-Effectiveness Ratio were calculated and statistical uncertainty was explored using a bootstrap simulation.


RESULTS
In terms of mean utility score at baseline, 3 and 6 months, no statistically significant difference was observed between the three groups. When considering the mean utility score changes from baseline to 3 and 6 months, no difference was observed in the first case but there was a statistically significant difference from baseline to 6 months with a p-value of 0.047. When comparing GS with paracetamol, the mean baseline incremental cost-effectiveness ratio (ICER) was dominant and the mean ICER after bootstrapping was -1376 euro/QALY indicating dominance (with 79% probability). When comparing GS with PBO, the mean baseline and after bootstrapping ICER were 3617.47 and 4285 euro/QALY, respectively.


CONCLUSIONS
The results of the present cost-effectiveness analysis suggested that GS is a highly cost-effective therapy alternative compared with paracetamol and PBO to treat patients diagnosed with primary knee OA.
Department of Public Health, University of Liege, Liege, Belgium.
S
S
Scholtissen
O
O
Bruyère
A
A
Neuprez
J L
JL
Severens
G
G
Herrero-Beaumont
L
L
Rovati
M
M
Hiligsmann
J Y
JY
Reginster
D000082:Acetaminophen / Q000191:economics / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D005260:Female; D005944:Glucosamine / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000188:drug therapy* / Q000191:economics; D019057:Quality-Adjusted Life Years; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D000082:Acetaminophen; D005944:Glucosamine