title: Cost-utility analysis of a multidisciplinary strategy to manage osteoarthritis of the knee: economic evaluation of a cluster randomized controlled trial study.
abstract: OBJECTIVE
  To determine if a pharmacist-initiated multidisciplinary strategy provides value for money compared to usual care in participants with previously undiagnosed knee osteoarthritis.
  
  
  METHODS
  Pharmacies were randomly allocated to provide either 1) usual care and a pamphlet or 2) intervention care, which consisted of education, pain medication management by a pharmacist, physiotherapy-guided exercise, and communication with the primary care physician. Costs and quality-adjusted life-years (QALYs) were determined for patients assigned to each treatment and incremental cost-effectiveness ratios (ICERs) were determined.
  
  
  RESULTS
  From the Ministry of Health perspective, the average patient in the intervention group generated slightly higher costs compared with usual care. Similar findings were obtained when using the societal perspective. The intervention resulted in ICERs of $232 (95% confidence interval [95% CI] -1,530, 2,154) per QALY gained from the Ministry of Health perspective and $14,395 (95% CI 7,826, 23,132) per QALY gained from the societal perspective, compared with usual care.
  
  
  CONCLUSIONS
  A pharmacist-initiated, multidisciplinary program was good value for money from both the societal and Ministry of Health perspectives.
authors.affiliation: University of British Columbia and Providence Health Care Institute, Vancouver, and Arthritis Research Centre of Canada, Richmond, British Columbia, Canada.
authors.forename: Carlo A
authors.initials: CA
authors.lastname: Marra
authors.forename: Maja
authors.initials: M
authors.lastname: Grubisic
authors.forename: Jolanda
authors.initials: J
authors.lastname: Cibere
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Grindrod
authors.forename: John C
authors.initials: JC
authors.lastname: Woolcott
authors.forename: Louise
authors.initials: L
authors.lastname: Gastonguay
authors.forename: John M
authors.initials: JM
authors.lastname: Esdaile
mesh_terms: D003131:Combined Modality Therapy / Q000191:economics / Q000592:standards; D003365:Costs and Cost Analysis; D005081:Exercise Therapy / Q000191:economics / Q000592:standards; D006801:Humans; D020370:Osteoarthritis, Knee / Q000191:economics* / Q000628:therapy; D059408:Pain Management / Q000191:economics* / Q000592:standards*; D010353:Patient Education as Topic / Q000191:economics / Q000592:standards; D010595:Pharmacists / Q000191:economics* / Q000592:standards*; D024382:Professional Role; D016896:Treatment Outcome