Mud-bath therapy in addition to usual care in bilateral knee osteoarthritis: Economic evaluation alongside a randomized controlled trial.
Arthritis Care and Research
© 2016, American College of Rheumatology
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OBJECTIVE: To perform a cost-effectiveness analysis of mud-bath therapy (MBT) in addition to usual treatment compared to usual treatment alone in patients with bilateral knee osteoarthritis (OA). METHODS: An economic evaluation alongside a randomized controlled trial was conducted. Patients were randomly assigned to receive either a 2 weeks cycle of MBT in addition to their usual treatment or to continue routine care alone. The European Quality-of-Life Questionnaire-5 Dimensions (EQ-5D) questionnaire was administered at baseline, 2 weeks, 3, 6, 9, and 12 months. Direct healthcare resource consumption data up until 12 months were derived from a daily diary given to patients and returned at prescheduled follow-up visits. RESULTS: A total of 103 patients were included (MBT = 53, control = 50). Overall, patients in the MBT group accrued on average 0.835 (± 0.10 standard deviation, SD) quality adjusted life years (QALYs) compared to 0.753 (± 0.11 SD) in the control group (p < 0.001). Average direct costs per patient (€303 vs €975, p < 0.001) were higher in the control group, primarily because of hospitalization for total knee replacement and use of intra-articular hyaluronic acid. Bootstrapping replications of costs and QALYs sample distributions consistently indicated that the MBT therapy combined with standard therapy represents a dominant strategy vis-à-vis standard therapy alone. The probability of MBT being cost-effective at standard cost-effectiveness thresholds (e.g. 20,000€/QALY) is 100%. CONCLUSION: The results of this cost-effectiveness analysis support the use of the mud bath therapy as mid-term complementary therapy in the management of knee OA. This article is protected by copyright. All rights reserved.
This study was funded by Tuscany Region. The study sponsor did not participate in the study design, collection, analysis, or interpretation of data.
Accepted manuscript online: 9 October 2016
This is the author accepted manuscript. The final version is available from the publisher via the DOI in this record.
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