Comparing the Cost-Effectiveness of the Otago Exercise Programme Among Older Women and Men: A Secondary Analysis of a Randomized Controlled Trial
Author(s)
Davis J1, Hsu CL1, Barha C2, Jehu DA3, Chan P2, Ghag C2, Jacova P2, Adjetey C4, Dian L2, Parmar N2, Madden K2, Liu-Ambrose T2
1University of British Columbia, Kamloops, BC, Canada, 2The University of British Columbia, Vancouver, BC, Canada, 3Augusta University, Augusta, GA, USA, 4University of British Columbia, Kelowna, BC, Canada
Objective: Using stratified analyses, we examined the cost-effectiveness of the OEP, from a health care system perspective, among women and men who have previously fallen. Methods: This study was a secondary stratified analyses (by women and men), of a 12-month prospective economic evaluation of a randomized clinical trial (OEP compared with usual care). Three hundred and forty four community-dwelling older adults (≥70; 172 OEP (110 women; 62 men), 172 usual care (119 women; 53 men)) who sustained a fall in the past 12 months and received a baseline assessment at the Vancouver Falls Prevention Clinic, Canada (www.fallsclinic.ca) were included. A gender by OEP/usual care interaction was examined for the falls incidence rate ratio (IRR). Outcome measures stratified by gender included: falls IRR, incremental cost-per fall prevented (ICER), incremental cost per quality adjusted life year (QALY, ICUR) gained, and mean total health care resource utilization costs. Results: Men were frailer that women at baseline. Men incurred higher mean total healthcare costs $6794 (SD: $11906)). There was no significant gender by OEP/usual care interaction on falls IRR. The efficacy of the OEP did not vary by gender. The adjusted IRR for the OEP group demonstrated a 39% (IRR: 0.61, CI: 0.40-0.93) significant reduction in falls among men but not women (32% reduction (IRR: 0.69, CI: 0.47-1.02)). The ICER showed the OEP was effective in preventing falls and less costly for men, while it was costlier for women by $42. The ICUR showed the OEP did not impact quality of life. Conclusion: Future studies should explore gender factors (i.e., health seeking behaviours, gender related frailty) that may explain observed variation in the cost-effectiveness of the OEP as a secondary falls prevention strategy. Trial Registrations: ClinicalTrials.gov Protocol Registration System Identifier: NCT01029171; URL: https://clinicaltrials.gov/ct2/show/NCT01029171 Identifier: NCT00323596; URL: https://clinicaltrials.gov/ct2/show/NCT00323596
Conference/Value in Health Info
2022-05, ISPOR 2022, Washington, DC, USA
Value in Health, Volume 25, Issue 6, S1 (June 2022)
Code
EE34
Topic
Economic Evaluation, Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes, Trial-Based Economic Evaluation
Disease
Geriatrics