title: Cost-Utility and Cost-Effectiveness Analyses of Face-to-Face Versus Telephone-Based Nonpharmacologic Multidisciplinary Treatments for Patients With Generalized Osteoarthritis.
abstract: OBJECTIVE
  To evaluate, from a societal perspective, the cost utility and cost effectiveness of a nonpharmacologic face-to-face treatment program compared with a telephone-based treatment program for patients with generalized osteoarthritis (GOA).
  
  
  METHODS
  An economic evaluation was carried out alongside a randomized clinical trial involving 147 patients with GOA. Program costs were estimated from time registrations. One-year medical and nonmedical costs were estimated using cost questionnaires. Quality-adjusted life years (QALYs) were estimated using the EuroQol (EQ) classification system, EQ rating scale, and the Short Form 6D (SF-6D). Daily function was measured using the Health Assessment Questionnaire (HAQ) disability index (DI). Cost and QALY/effect differences were analyzed using multilevel regression analysis and cost-effectiveness acceptability curves.
  
  
  RESULTS
  Medical costs of the face-to-face treatment and telephone-based treatment were estimated at €387 and €252, respectively. The difference in total societal costs was nonsignificantly in favor of the face-to-face program (difference €708; 95% confidence interval [95% CI] -€5,058, €3,642). QALYs were similar for both groups according to the EQ, but were significantly in favor of the face-to-face group, according to the SF-6D (difference 0.022 [95% CI 0.000, 0.045]). Daily function was similar according to the HAQ DI. Since both societal costs and QALYs/effects were in favor of the face-to-face program, the economic assessment favored this program, regardless of society's willingness to pay. There was a 65-90% chance that the face-to-face program had better cost utility and a 60-70% chance of being cost effective.
  
  
  CONCLUSIONS
  This economic evaluation from a societal perspective showed that a nonpharmacologic, face-to-face treatment program for patients with GOA was likely to be cost effective, relative to a telephone-based program.
authors: Sint Maartenskliniek, Nijmegen, The Netherlands.
authors: Nienke
authors: N
authors: Cuperus
authors: Leiden University Medical Center, Leiden, The Netherlands.
authors: Wilbert B
authors: WB
authors: van den Hout
authors: Maastricht University, Maastricht, The Netherlands.
authors: Thomas J
authors: TJ
authors: Hoogeboom
authors: Sint Maartenskliniek, Nijmegen, The Netherlands.
authors: Frank H J
authors: FH
authors: van den Hoogen
authors: Leiden University Medical Center, Leiden, The Netherlands.
authors: Thea P M
authors: TP
authors: Vliet Vlieland
authors: Sint Maartenskliniek, Nijmegen, The Netherlands.
authors: Cornelia H M
authors: CH
authors: van den Ende
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D004185:Disability Evaluation; D005260:Female; D017048:Health Care Costs; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D009426:Netherlands; D009819:Office Visits / Q000191:economics*; D010003:Osteoarthritis / Q000175:diagnosis / Q000191:economics* / Q000503:physiopathology / Q000628:therapy*; D010348:Patient Care Team / Q000191:economics; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D020127:Recovery of Function; D012044:Regression Analysis; D019114:Remote Consultation / Q000191:economics*; D012219:Rheumatology / Q000191:economics* / Q000379:methods; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D013689:Telephone / Q000191:economics*; D013997:Time Factors; D016896:Treatment Outcome