An economic evaluation of knee osteoarthritis treatments in Thailand

Objective: The objective of this study is to evaluate the cost-effectiveness of different knee OA care sequences compared to standard treatment reimbursed by the major health insurance payer in Thailand.Method: We used decision analytical modeling to evaluate the effect of either adding etoricoxib o...

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Main Authors: Parnnaphat Luksameesate, Aree Tanavalee, Suthira Taychakhoonavudh
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-09-01
Series:Frontiers in Pharmacology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2022.926431/full
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author Parnnaphat Luksameesate
Aree Tanavalee
Suthira Taychakhoonavudh
author_facet Parnnaphat Luksameesate
Aree Tanavalee
Suthira Taychakhoonavudh
author_sort Parnnaphat Luksameesate
collection DOAJ
description Objective: The objective of this study is to evaluate the cost-effectiveness of different knee OA care sequences compared to standard treatment reimbursed by the major health insurance payer in Thailand.Method: We used decision analytical modeling to evaluate the effect of either adding etoricoxib or crystalline glucosamine sulfate compared to standard treatment from a societal perspective over patients’ lifetimes. Data were analyzed based on efficacy, whereas adverse events were considered as a substate. Model input data were retrieved from relevant published literature and the Standard Cost Lists for Health Technology Assessment, Thailand. All health outcomes were measured in a unit of quality-adjusted life-year (QALY). An incremental cost-effectiveness ratio (ICER) was applied to examine the costs and QALYs. Sensitivity analysis was performed to investigate the robustness of the model.Result: The results demonstrated that adding crystalline glucosamine sulfate (before diclofenac plus proton pump inhibitors, PPI) into the standard care sequence was a dominant strategy compared to the standard care sequence. Adding etoricoxib alone or including crystalline glucosamine sulfate (after diclofenac plus PPI) was dominated by adding crystalline glucosamine sulfate (before diclofenac plus PPI), whereas in a willingness-to-pay (WTP) threshold in Thailand, adding of both crystalline glucosamine sulfate (before diclofenac plus PPI) and etoricoxib were cost-effective when compared to adding crystalline glucosamine sulfate alone with ICER of 125,547 Thai baht/QALY (3,472 US dollars/QALY).Conclusion: The addition of crystalline glucosamine sulfate and etoricoxib into standard knee OA treatment were cost-effective at the WTP threshold in Thailand. In addition, early initiation of crystalline glucosamine sulfate would be less costly and more effective than delayed treatment or the use of standard treatment alone.
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spelling doaj.art-d8ea3dd1ac574e58a7f89b7ad3f3fb9d2022-12-22T04:26:01ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-09-011310.3389/fphar.2022.926431926431An economic evaluation of knee osteoarthritis treatments in ThailandParnnaphat Luksameesate0Aree Tanavalee1Suthira Taychakhoonavudh2Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, ThailandDepartment of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, ThailandDepartment of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandObjective: The objective of this study is to evaluate the cost-effectiveness of different knee OA care sequences compared to standard treatment reimbursed by the major health insurance payer in Thailand.Method: We used decision analytical modeling to evaluate the effect of either adding etoricoxib or crystalline glucosamine sulfate compared to standard treatment from a societal perspective over patients’ lifetimes. Data were analyzed based on efficacy, whereas adverse events were considered as a substate. Model input data were retrieved from relevant published literature and the Standard Cost Lists for Health Technology Assessment, Thailand. All health outcomes were measured in a unit of quality-adjusted life-year (QALY). An incremental cost-effectiveness ratio (ICER) was applied to examine the costs and QALYs. Sensitivity analysis was performed to investigate the robustness of the model.Result: The results demonstrated that adding crystalline glucosamine sulfate (before diclofenac plus proton pump inhibitors, PPI) into the standard care sequence was a dominant strategy compared to the standard care sequence. Adding etoricoxib alone or including crystalline glucosamine sulfate (after diclofenac plus PPI) was dominated by adding crystalline glucosamine sulfate (before diclofenac plus PPI), whereas in a willingness-to-pay (WTP) threshold in Thailand, adding of both crystalline glucosamine sulfate (before diclofenac plus PPI) and etoricoxib were cost-effective when compared to adding crystalline glucosamine sulfate alone with ICER of 125,547 Thai baht/QALY (3,472 US dollars/QALY).Conclusion: The addition of crystalline glucosamine sulfate and etoricoxib into standard knee OA treatment were cost-effective at the WTP threshold in Thailand. In addition, early initiation of crystalline glucosamine sulfate would be less costly and more effective than delayed treatment or the use of standard treatment alone.https://www.frontiersin.org/articles/10.3389/fphar.2022.926431/fullknee osteoarthritiseconomic evaluationcost-utility analysisglucosamineetoricoxib
spellingShingle Parnnaphat Luksameesate
Aree Tanavalee
Suthira Taychakhoonavudh
An economic evaluation of knee osteoarthritis treatments in Thailand
Frontiers in Pharmacology
knee osteoarthritis
economic evaluation
cost-utility analysis
glucosamine
etoricoxib
title An economic evaluation of knee osteoarthritis treatments in Thailand
title_full An economic evaluation of knee osteoarthritis treatments in Thailand
title_fullStr An economic evaluation of knee osteoarthritis treatments in Thailand
title_full_unstemmed An economic evaluation of knee osteoarthritis treatments in Thailand
title_short An economic evaluation of knee osteoarthritis treatments in Thailand
title_sort economic evaluation of knee osteoarthritis treatments in thailand
topic knee osteoarthritis
economic evaluation
cost-utility analysis
glucosamine
etoricoxib
url https://www.frontiersin.org/articles/10.3389/fphar.2022.926431/full
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