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Cost-effectiveness of the Arthritis Self-Help Course
Judy M. S. Kruger, MS, MPH;
Charles G. Helmick, MD;
Leigh F. Callahan, PhD;
Anne C. Haddix, PhD
Arch Intern Med. 1998;158:1245-1249.
Objective To evaluate the cost-effectiveness of the Arthritis Self-Help Course in reducing the pain of arthritis, the leading cause of disability in the United States and a common problem among older adults.
Methods A decision model was used to examine the cost-effectiveness of the Arthritis Self-Help Course among individuals with arthritis over a 4-year analytic horizon from 2 perspectives, namely, society and the health care system. The Arthritis Self-Help Course was assumed to reduce pain by 20% and physician visits for arthritis by 40% among individuals receiving conventional medical therapy. Estimates for program costs, costs for physician visits, and time and transportation costs were derived from the published literature and expert opinion. Sensitivity analyses were conducted on all relevant parameters. Arthritis pain and costs (program, physician visit plus/minus time and transportation) were expressed as cost per person per unit reduction in pain. Because nearly all analyses showed the program to be cost saving, we simply report the reduction in joint pain and the cost savings, because standardizing cost savings is not a useful concept.
Results From both the societal and health care system perspectives, the Arthritis Self-Help Course was cost saving in base-case analyses (reducing pain by 0.9 units while saving $320 and $267, respectively) and throughout the range of reasonable values used in univariate sensitivity analyses. Cost savings were due primarily to reduced physician visits.
Conclusions The Arthritis Self-Help Course is a cost-saving intervention that further reduces arthritis pain among individuals receiving conventional medical therapy. The benefits for both patients and health care providers warrant its more widespread use as a normal adjunct to conventional therapy.
From the University of Illinois at Chicago School of Public Health (Ms Kruger); Health Care and Aging Studies Branch, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion (Drs Helmick and Callahan) and Prevention Effectiveness Branch, Division of Prevention Research and Analytic Methods, Epidemiology Program Office (Dr Haddix), Centers for Disease Control and Prevention, Atlanta, Ga. Dr Callahan is now with the Thurston Arthritis Research Center, University of North Carolina at Chapel Hill.
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