Cost-Effectiveness of Concurrent Korean and Western Medicine Treatment vs. Usual Care for Car Accident-Related Whiplash Injuries in Korea: A Markov Model Decision Analysis
Author(s)
Namkwen Kim, MPH, PhD, MD.
Korean Medicine, Center for Big data & Comparative Effectiveness Research, Economic Evaluation in Health and Medicine, Research institute for Korean Medicine, Yangsan city, Korea, Republic of.
Korean Medicine, Center for Big data & Comparative Effectiveness Research, Economic Evaluation in Health and Medicine, Research institute for Korean Medicine, Yangsan city, Korea, Republic of.
OBJECTIVES: Many patients with car accident-related injuries in South Korea are treated with concurrent Korean Medicine (KM) and Western Medicine (WM). This study aims to evaluate the cost-effectiveness of concurrent treatment compared to usual care for whiplash patients in South Korea.
METHODS: A Markov model was used to estimate the cost-effectiveness of both treatment alternatives. The model had a 1-year cycle length and a 3-year time horizon. Input parameters for conducting analyses were derived from real-world data in Korea. We used Korean national health insurance and healthcare panel data to estimate and compare the cost and utility parameters of both treatments. Statistical comparisons were made using t-tests and hierarchical logistic regression analysis for estimating hazard ratios. All statistical analyses were performed using StataMP (version 18) with a significance level of p<0.05, and the Markov model decision analyses were conducted using R Studio program (R version 4.2.0). The economic evaluation adopted a healthcare payer perspective based on Korean national health insurance guidelines.
RESULTS: We simulated 1,000 50-year-old male patients with whiplash from car accidents. The mean cost of usual care was 237,475 KRW, while concurrent treatment cost 397,986 KRW. The mean utility for the usual care group was 2.687 QALYs, and for the concurrent treatment group, it was 2.691 QALYs. The deterministic analysis showed an ICER of 53,934,984 KRW per QALY. Probabilistic sensitivity analysis yielded a similar ICER of 49,654,962 KRW per QALY, with a 45.9% probability of cost-effectiveness at the national health insurance threshold (30,500,000 KRW/QALY) and a 50.8% probability at the South Korean GDP-based threshold (54,000,000 KRW/QALY).
CONCLUSIONS: Depending on the reimbursement thresholds, concurrent KM and WM treatment for whiplash injuries may be a cost-effective alternative to usual care in South Korea. Future research, including real-world pragmatic trials or economic evaluations alongside randomized controlled trials (RCTs), is needed to support these findings.
METHODS: A Markov model was used to estimate the cost-effectiveness of both treatment alternatives. The model had a 1-year cycle length and a 3-year time horizon. Input parameters for conducting analyses were derived from real-world data in Korea. We used Korean national health insurance and healthcare panel data to estimate and compare the cost and utility parameters of both treatments. Statistical comparisons were made using t-tests and hierarchical logistic regression analysis for estimating hazard ratios. All statistical analyses were performed using StataMP (version 18) with a significance level of p<0.05, and the Markov model decision analyses were conducted using R Studio program (R version 4.2.0). The economic evaluation adopted a healthcare payer perspective based on Korean national health insurance guidelines.
RESULTS: We simulated 1,000 50-year-old male patients with whiplash from car accidents. The mean cost of usual care was 237,475 KRW, while concurrent treatment cost 397,986 KRW. The mean utility for the usual care group was 2.687 QALYs, and for the concurrent treatment group, it was 2.691 QALYs. The deterministic analysis showed an ICER of 53,934,984 KRW per QALY. Probabilistic sensitivity analysis yielded a similar ICER of 49,654,962 KRW per QALY, with a 45.9% probability of cost-effectiveness at the national health insurance threshold (30,500,000 KRW/QALY) and a 50.8% probability at the South Korean GDP-based threshold (54,000,000 KRW/QALY).
CONCLUSIONS: Depending on the reimbursement thresholds, concurrent KM and WM treatment for whiplash injuries may be a cost-effective alternative to usual care in South Korea. Future research, including real-world pragmatic trials or economic evaluations alongside randomized controlled trials (RCTs), is needed to support these findings.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD205
Topic Subcategory
Distributed Data & Research Networks
Disease
STA: Alternative Medicine