Cost-Effectiveness of Primary and Community Care Programmes for Osteoarthritis: A Modeling Study Using Data From a Multi-Center National Pilot Program
Author(s)
J. Haxby Abbott, PhD, DPT, FNZCP1, Ross Wilson, PhD2.
1Research Professor, University of Otago, Dunedin, New Zealand, 2Centre for Musculoskeletal Outcomes Research, University of Otago, Dunedin, New Zealand.
1Research Professor, University of Otago, Dunedin, New Zealand, 2Centre for Musculoskeletal Outcomes Research, University of Otago, Dunedin, New Zealand.
OBJECTIVES: Musculoskeletal conditions are the leading cause of disability internationally as well as in New Zealand (NZ). Osteoarthritis (OA) is among the most common musculoskeletal conditions in adults, and causes a significant morbidity and economic burden. The NZ Government Ministry of Health initiated the Mobility Action Programme (MAP), a pragmatic pilot initiative to investigate what would be the benefits of delivering early-intervention, community-based programmes for people with musculoskeletal health conditions. This study aims to investigate the cost-effectiveness of intervention programmes for adults with OA.
METHODS: We used real-world data from 17 providers across NZ delivering the MAP, with n=3,922 participants’ outcomes to 1-year follow-up. As the MAP did not include a control group we used previously collected randomised controlled trial data for ‘usual care’ outcomes (n=51). Using the NZ-MOA state-transition microsimulation model, a simulated matching population cohort was run through two scenarios: (1) background ‘usual care’ assumed to be received in the absence of MAP participation, and (2) the MAP programme in addition usual care.
RESULTS: Over the 1-year time horizon, incremental QALY gains were 0.03 (90% UI 0.02 to 0.04) and incremental treatment costs were −$793 (−$4 214 to $2 490) per MAP participant. Over the 15-year modelled time horizon QALY gains relative to usual care continued to accumulate, albeit at a decreasing rate, reaching 0.14 (0.10 to 0.18) per participant. Incremental healthcare costs were negative over all time horizons, reaching total cost savings of $14 555 ($47 527 cost saving to $17 167 cost increase) per participant over 15 years. The incremental net monetary benefit, at willingness-to-pay of $57 500 per QALY, increased from $2 341 (−$944 to $5 658) per participant over 1-year horizon to $22 441 (−$9 227 to $54 729) over 15 years.
CONCLUSIONS: The MAP increased health-related quality of life and was cost-saving compared with usual care for adults with OA.
METHODS: We used real-world data from 17 providers across NZ delivering the MAP, with n=3,922 participants’ outcomes to 1-year follow-up. As the MAP did not include a control group we used previously collected randomised controlled trial data for ‘usual care’ outcomes (n=51). Using the NZ-MOA state-transition microsimulation model, a simulated matching population cohort was run through two scenarios: (1) background ‘usual care’ assumed to be received in the absence of MAP participation, and (2) the MAP programme in addition usual care.
RESULTS: Over the 1-year time horizon, incremental QALY gains were 0.03 (90% UI 0.02 to 0.04) and incremental treatment costs were −$793 (−$4 214 to $2 490) per MAP participant. Over the 15-year modelled time horizon QALY gains relative to usual care continued to accumulate, albeit at a decreasing rate, reaching 0.14 (0.10 to 0.18) per participant. Incremental healthcare costs were negative over all time horizons, reaching total cost savings of $14 555 ($47 527 cost saving to $17 167 cost increase) per participant over 15 years. The incremental net monetary benefit, at willingness-to-pay of $57 500 per QALY, increased from $2 341 (−$944 to $5 658) per participant over 1-year horizon to $22 441 (−$9 227 to $54 729) over 15 years.
CONCLUSIONS: The MAP increased health-related quality of life and was cost-saving compared with usual care for adults with OA.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD197
Topic Subcategory
Distributed Data & Research Networks
Disease
SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)