title: A reference case for economic evaluations in osteoarthritis: an expert consensus article from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).
abstract: BACKGROUND
  General recommendations for a reference case for economic studies in rheumatic diseases were published in 2002 in an initiative to improve the comparability of cost-effectiveness studies in the field. Since then, economic evaluations in osteoarthritis (OA) continue to show considerable heterogeneity in methodological approach.
  
  
  OBJECTIVE
  To develop a reference case specific for economic studies in OA, including the standard optimal care, with which to judge new pharmacologic and non-pharmacologic interventions.
  
  
  METHODS
  Four subgroups of an ESCEO expert working group on economic assessments (13 experts representing diverse aspects of clinical research and/or economic evaluations) were charged with producing lists of recommendations that would potentially improve the comparability of economic analyses in OA: outcome measures, comparators, costs and methodology. These proposals were discussed and refined during a face-to-face meeting in 2013. They are presented here in the format of the recommendations of the recently published Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement, so that an initiative on economic analysis methodology might be consolidated with an initiative on reporting standards.
  
  
  RESULTS
  Overall, three distinct reference cases are proposed, one for each hand, knee and hip OA; with diagnostic variations in the first two, giving rise to different treatment options: interphalangeal or thumb-based disease for hand OA and the presence or absence of joint malalignment for knee OA. A set of management strategies is proposed, which should be further evaluated to help establish a consensus on the "standard optimal care" in each proposed reference case. The recommendations on outcome measures, cost itemisation and methodological approaches are also provided.
  
  
  CONCLUSIONS
  The ESCEO group proposes a set of disease-specific recommendations on the conduct and reporting of economic evaluations in OA that could help the standardisation and comparability of studies that evaluate therapeutic strategies of OA in terms of costs and effectiveness.
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: m.hiligsmann@maastrichtuniversity.nl.
authors.forename: Mickaël
authors.initials: M
authors.lastname: Hiligsmann
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Cooper
authors.affiliation: Université de Lorraine, Nancy, France; Université Paris Descartes, Paris, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Guillemin
authors.affiliation: Division of Rheumatology & Clinical Immunology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD; Geriatric Research Education and Clinical Center, VA Maryland Health Care System, Baltimore, MD.
authors.forename: Marc C
authors.initials: MC
authors.lastname: Hochberg
authors.affiliation: Department of Medicine, University of Ottawa, Ottawa, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Tugwell
authors.affiliation: NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
authors.forename: Nigel
authors.initials: N
authors.lastname: Arden
authors.affiliation: University of Paris 06-INSERM UMR-S 938, Paris, France; Department of Rheumatology, AP-HP Saint-Antoine Hospital, Paris, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Berenbaum
authors.affiliation: Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands; Department of Rheumatology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: Boers
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Center, The Netherlands; School for Public Health and Primary Care (CAPHRI), Maastricht University, The Netherlands.
authors.forename: Annelies
authors.initials: A
authors.lastname: Boonen
authors.affiliation: CEDOC, Bayamon, Puerto Rico; Department of Rheumatology, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal; CHLO, EPE-Hospital Egas Moniz, Lisbon, Portugal.
authors.forename: Jaime C
authors.initials: JC
authors.lastname: Branco
authors.affiliation: Department of Internal Medicine, University of Florence, Florence, Italy.
authors.forename: Brandi
authors.initials: B
authors.lastname: Maria-Luisa
authors.affiliation: Department of Public Health, Epidemiology and Health Economics, University of Liege, Liege, Belgium.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bruyère
authors.affiliation: Department of Public Health and Health Management, University of Medicine and Pharmacy of Tirgu Mures, Romania.
authors.forename: Andrea
authors.initials: A
authors.lastname: Gasparik
authors.affiliation: WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
authors.forename: John A
authors.initials: JA
authors.lastname: Kanis
authors.affiliation: Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Tore K
authors.initials: TK
authors.lastname: Kvien
authors.affiliation: Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
authors.forename: Johanne
authors.initials: J
authors.lastname: Martel-Pelletier
authors.affiliation: Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Pelletier
authors.affiliation: NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
authors.forename: Rafael
authors.initials: R
authors.lastname: Pinedo-Villanueva
authors.affiliation: Department of Physical Therapy and Human Movement Sciences/Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL.
authors.forename: Daniel
authors.initials: D
authors.lastname: Pinto
authors.affiliation: Federal Institute for Drugs and Medical Devices (BfArM), Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Reiter-Niesert
authors.affiliation: Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
authors.forename: René
authors.initials: R
authors.lastname: Rizzoli
authors.affiliation: Clinical Research Unit, Rottapharm/Madaus, Monza, Italy.
authors.forename: Lucio C
authors.initials: LC
authors.lastname: Rovati
authors.affiliation: Institute of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: Johan L
authors.initials: JL
authors.lastname: Severens
authors.affiliation: Cedars-Sinai Bone Center of Excellence, UCLA School of Medicine, OMC Clinical Research Center, Beverly Hills, CA.
authors.forename: Stuart
authors.initials: S
authors.lastname: Silverman
authors.affiliation: Department of Public Health, Epidemiology and Health Economics, University of Liege, Liege, Belgium.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Reginster
mesh_terms: D003362:Cost-Benefit Analysis; D019468:Disease Management; D005060:Europe; D006225:Hand; D006801:Humans; D010003:Osteoarthritis / Q000191:economics* / Q000628:therapy*; D015207:Osteoarthritis, Hip / Q000191:economics / Q000628:therapy; D020370:Osteoarthritis, Knee / Q000191:economics / Q000628:therapy; D017063:Outcome Assessment, Health Care; D012955:Societies, Medical
keywords: Comparative effectiveness; Cost-effectiveness analysis; Cost–utility analysis; Economics; Hand; Hip; Knee; Methods; Osteoarthritis; Outcome assessment; Reference case; Rheumatic disease