Evidence-based medicine is affordable: The cost-effectiveness of current compared with optimal treatment in rheumatoid and osteoarthritis

Andrews, G., Simonella, L., Lapsley, H., Sanderson, K. and March, L. (2006) Evidence-based medicine is affordable: The cost-effectiveness of current compared with optimal treatment in rheumatoid and osteoarthritis. Journal of Rheumatology, 33 4: 671-680.


Author Andrews, G.
Simonella, L.
Lapsley, H.
Sanderson, K.
March, L.
Title Evidence-based medicine is affordable: The cost-effectiveness of current compared with optimal treatment in rheumatoid and osteoarthritis
Journal name Journal of Rheumatology   Check publisher's open access policy
ISSN 0315-162X
Publication date 2006
Sub-type Article (original research)
Volume 33
Issue 4
Start page 671
End page 680
Total pages 10
Place of publication Toronto, Canada
Publisher Journal of Rheumatology Publishing
Collection year 2006
Language eng
Subject C1
321028 Rheumatology and Arthritis
730308 Health policy economic outcomes
1103 Clinical Sciences
Abstract Objective. To determine the cost-effectiveness of averting the burden of disease. We used secondary population data and metaanalyses of various government-funded services and interventions to investigate the costs and benefits of various levels of treatment for rheumatoid arthritis (RA) and osteoarthritis (OA) in adults using a burden of disease framework. Method. Population burden was calculated for both diseases in the absence of any treatment as years lived with disability (YLD), ignoring the years of life lost. We then estimated the proportion of burden averted with current interventions, the proportion that could be averted with optimally implemented cut-rent evidence-based guidelines, and the direct treatment cost-effectiveness ratio in dollars per YLD averted for both treatment levels. Results. The majority of people with arthritis sought medical treatment. Current treatment for RA averted 26% of the burden, with a cost-effectiveness ratio of $19,000 per YLD averted. Optimal, evidence-based treatment would avert 48% of the burden. with a cost-effectiveness ratio of $12,000 per YLD averted. Current treatment of OA in Australia averted 27% of the burden, with a cost-effectiveness ratio of $25,000 per YLD averted. Optimal, evidence-based treatment would avert 39% of the burden, with an unchanged cost-effectiveness ratio of $25,000 per YLD averted. Conclusion. While the precise dollar costs in each country will differ, the relativities at this level of coverage should remain the same. There is no evidence that closing the gap between evidence and practice would result in a drop in efficiency.
Keyword Rheumatology
Osteoarthritis
Rheumatoid Arthritis
Cost Effectiveness
Efficiency
Knee Replacement Surgery
Quality-of-life
Controlled-trial
Combination Therapy
Managing Arthritis
Health-status
Total Hip
Management
Recommendations
Methotrexate
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2007 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 08:06:30 EST