Table 2.
Characteristics of CEA studies in the pharmacological management of OA (43 studies)
| Study/QHES score | Country/region | Type of study | Perspective | Comparators | Time period/discount rate | Costs | Outcome | Year, currency | SA |
|---|---|---|---|---|---|---|---|---|---|
| Haglund 2000 [40]/75 | Sweden | Swedish ACCES model | Sweden direct medical costs |
Celecoxib vs NSAID monotherapy Celecoxib vs base case |
1 y/5% | Direct costs |
GI event averted LYG |
1998, SEK | One-way SA |
| Svarvar 2000 [41]/84 | Norway | ACCES model | Societal |
Celecoxib vs NSAID monotherapy Celecoxib vs base case |
6 mo/5% | Direct costs |
GI event averted LYG |
1999, USD | One-way SA |
| Torrance 2002 [45]/94 | Canada | Multicenter, open-label randomized parallel-group design | Societal and HCS | Hylan G-F 20 + appropriate care vs appropriate care | 1 y/NA | Direct costs, productivity loss, other indirect costs |
QALY (HUI3) WOMAC |
1999, CAD | DSA |
| Kamath 2003 [42]/88 | USA | Decision tree | Healthcare payer | Ibuprofen vs acetaminophen | 6 mo/NA | Direct costs |
GI event averted MPCI (WOMAC) |
2000, USD | DSA PSA |
| Moore 2004 [43]/82 | UK | Decision-analytic model | NHS |
Etoricoxib vs NSAIDs alone Etoricoxib vs NSAIDs + H2A |
1 y/1.5% | Direct costs |
PUB avoided QALY |
2002, GBP | One-way SA, PSA |
| Yen 2004 [44]/94 | Taiwan | Decision tree | Societal | Celecoxib vs naproxen | 26 wk/NR | Direct costs, productivity loss | QALY (standard gamble) | 2002, USD | DSA |
| Marshall 2006 [51]/94 | USA | Multicenter, open-label randomized parallel-group design | HCS and societal | Oxycodone vs oxycodone-paracetamol | 4 mo/NR | Direct costs, productivity loss |
QALY (HUI3) WOMAC |
2005, USD | DSA, PSA |
| Loyd 2007 [46]/91 | USA | Decision tree | Societal | Celecoxib vs NSAIDs | Lifetime/3% | Direct costs | QALY | 2006, USD | One-way SA |
| Ward 2007 [47]/84 | Germany | Discrete event simulation | German health insurance system | OROS hydromorphone vs ER oxycodone | 1 y/NR | Direct costs | QALY (translate SPI to SF-6D) | 2005, EUR | DSA, PSA |
| Contreras-Hernandez 2008 [37]/68 | Mexico | Decision tree | Societal | Celecoxib vs NSAIDs | 6 mo/NA | Direct costs | No. of patients with pain control and no AE | 2008, USD | DSA, PSA |
| Castelnuovo 2008 [52]/94 | UK | TOIB | NHS and societal | Oral vs topical ibuprofen | 1 & 2 y/6% | Direct costs | QALY (EQ-5D) | 2005, GBP | DSA, PSA |
| Bruyère 2009 [34]/73 | France, Belgium, Switzerland, Austria, USA | STOPP | Public | Chondroitin sulfate vs placebo | 2 y/NR | Drug costs | QALY (translate WOMAC to HUI) | 2009, EUR | DSA |
| Chou 2009 [35]/70 | Taiwan | NR | Societal | Hylan G-F 20 vs sodium hyaluronate | 6 mo/NR | Direct costs | QALY (VAS), HSS, WOMAC, Lequesne’s index | 2006, TWD | NR |
| Bessette 2009 [48]/85 | Canada | Markov model | A third-party payer | Celecoxib as first- vs second-line treatment | 5 y/3% | Direct costs | QALY | 2005, CAD | One-way SA |
| Black 2009 [49]/87 | UK | Cohort simulation | NHS | Glucosamine sulfate + current care vs current care | Lifetime/NR | Direct costs | QALY (translate WOMAC to HUI) | 2008, GBP | DSA, PSA |
| Latimer 2009 [50]/94 | UK | Markov model | NHS | Celecoxib + PPI vs etoricoxib + PPI | 3 mo/3.5% | Direct costs | QALY (translate WOMAC to EQ-5D) | 2007, GBP | DSA, PSA |
| Scholtissen 2010 [61]/91 | Spain, Portugal | GUIDE | HCS | Glucosamine sulfate vs paracetamol | 6 mo/NR | Drug costs | QALY (translate WOMAC to HUI) | 2010, EUR | PSA |
| Brereton 2012 [53]/94 | UK | Markov model | NHS | Celecoxib + PPI vs diclofenac + PPI | 3 mo/3.5% | Direct costs | QALY (translate WOMAC to EQ-5D) | 2011, GBP | DSA, PSA |
| Turajane 2012 [62]/84 | Thailand | Prospective observational study | HCS | Celecoxib vs NSAIDs | 6 mo/NR | Direct costs | QALY (EQ-5D) | 2011, THB | NR |
| Wielage 2013 [54]/76 | Canada | Markov model | Societal | Duloxetine vs celecoxib | 3 mo/5% | Direct costs | QALY (translate patient-level pain to EQ-5D) | 2011, CAD | One-way SA, PSA |
| Wielage 2013 [55]/86 | USA | Discrete-state, time-dependent semi-Markov model | US private payer | Duloxetine vs naproxen | Lifetime/3% | Direct costs | QALY, WOMAC | 2011, USD | One-way SA, PSA |
| Wielage 2013 [56]/75 | USA | Markov model | US private payer | Duloxetine vs naproxen | Lifetime/16% | Direct costs | QALY (EQ-5D) | 2011, USD | One-way SA, PSA |
| Brereton 2014 [57]/79 | Sweden | NICE OA model | NHS | Celecoxib + PPI vs diclofenac + PPI | Lifetime/3% | Direct costs | QALY | 2012, USD | PSA |
| Capel 2014 [58]/86 | Spain | Markov model | NHS |
Naproxen + esomeprazole vs ibuprofen + PPI Naproxen + esomeprazole vs naproxen + PPI |
1 y/NA | Direct costs | QALY, WOMAC | 2012, EUR | DSA, PSA |
| Hatoum 2014 [59]/86 | USA | Decision analytic model | Payer | Bioengineered hyaluronic acid + conventional care vs conventional care | 52 wk/NR | Direct costs | QALY (HUI3), WOMAC | 2012, USD | One-way SA, PSA |
| Wielage 2014 [60]/77 | Canada | Semi-Markov model | Societal | Celecoxib vs diclofenac | 3 mo/5% | Direct costs | QALY, WOMAC | 2011, CAD | One-way SA, PSA |
| Castro 2015 [65]/83 | Colombia | Discrete-event simulation model | Third-party payer | Hylan G-F 20 vs CST | 5–20 y/3% | Direct costs | QALY (WOMAC) | 2012, USD | PSA |
| Nasef 2015 [66]/83 | Saudi Arabia | Markov model | Patient | Ibuprofen + PPI vs no treatment | 3 mo/3% | Direct costs | QALY (translate WOMAC to EQ-5D) | 2013, USD | PSA |
| Katz 2016 [67]/86 | USA | OAPol model | Clinical policy |
OTC naproxen vs ibuprofen Naproxen Rx + OTC PPI vs OTC naproxen |
5 y/3% | Direct costs | QALY, WOMAC | 2013, USD | One- and two-way SA, PSA |
| Rosen 2016 [68]/94 | USA | Grootendorst model | Payer | Euflexxa + conventional care vs conventional care | 6 mo/NR | Direct costs | QALY (translate WOMAC to HUI-3) | 2015, USD | One-way SA |
| Bellamy 2016 [36]/72 | USA | Randomized, double-blind, prospective study | NR | Ketorolac vs corticosteroid (injection) | 3 y/NR | Direct costs | QALY, VAS, WOMAC, KSS, TL Knee Scoring Scale, SF-36, UCLA activity score | 2015, USD | NR |
| Thomas 2017 [63]/87 | France | Observational, prospective and multicenter study | Third-party payer | HA (Arthrum H 2%) vs NSAIDs | 6 mo/NR | Direct costs | QALY (EQ-5D), WOMAC, EQ-VAS | 2014, EUR | NR |
| Smith 2017 [69]/86 | USA | OAPol model | Societal |
Tramadol vs opioid-sparing Tramadol + oxycodone vs opioid-sparing |
3–12 mo/3% | Direct costs | QALY, delay and reduction of utilization of TKA | 2014, USD | PSA |
| Hermans 2018 [64]/84 | Netherlands | Randomized clinical trial | Societal and HCS | Usual care + HMW-HA (Hylan G-F 20) vs usual care | 52 wk/NR | Productivity and medical costs | QALY (EQ-5D) | 2010, EUR | PSA |
| Losina 2018 [70]/86 | USA | OAPol model | HCS |
Celecoxib vs OTC naproxen OTC naproxen + OTC PPIs vs OTC naproxen |
Lifetime/3% | Direct costs | QALY, WOMAC | 2015, USD | PSA |
| Migliore 2019 [38]/68 | Italy | Markov model | NHS |
Hylan G-F 20 (1×6 mL) vs acetaminophen Hylan G-F 20 (3×2 mL) vs acetaminophen |
5 y/3.5% | Direct costs | QALY, no. of patients with reduction in knee OA symptoms | 2016, EUR | One-way SA, PSA |
| Rosen 2019 [39]/73 | USA | Tree diagram | Payer | HMW HA vs NSAID/analgesic medication | 6 mo/NR | Direct costs | QALY | 2019, USD | One-way SA |
| Rosen 2020 [71]/79 | USA | Decision analytic models | Payer | HMW HA vs LMW HA | 6 mo/NR | Direct costs | QALY | 2019, USD | One-way SA |
| Samuelson 2020 [72]/90 | USA | Tree diagram | Payer | PRP vs HA | 1 y/3% | Direct costs | QALY, WOMAC (EQ-5D) | 2019, USD | TSA |
| Karasawa 2021 [74]/93 | Japan | Markov model | NHS | Celecoxib vs ioxoprofen | Lifetime/2% | Direct costs | QALY PUB avoided | 2021, JPY/USD | One-way SA, PSA |
| Sun 2021 [76]/80 | China | Markov model | Healthcare |
Diclofenac vs diclofenac + PPI Diclofenac vs imrecoxib Imrecoxib vs imrecoxib + PPI Diclofenac + PPI vs imrecoxib + PPI |
Lifetime/5% | Direct costs | QALY | 2019, USD | PSA, DSA |
| Sullivan 2021 [75]/94 | USA | OAPol model | Healthcare | Usual care vs duloxetine + usual care | Lifetime/3% | Direct costs | QALY | 2018, USD | One-way SA, Two-way SA, PSA |
| Chirikov 2021 [73]/80 | United Arab Emirates | Discrete-state Markov model | Payer |
Celecoxib vs ibuprofen Celecoxib vs naproxen |
30 mo/3% | Direct costs | QALY | 2019, USD | PSA, DSA |
ACCES Arthritis Cost Consequence Evaluation System, AE adverse event, CAD Canadian dollar, CEA cost-effectiveness analysis, CST conventional supportive therapy, DSA deterministic sensitivity analysis, ER extended-release, EUR Euro, GBP British pound sterling, GI gastrointestinal, GUIDE Glucosamine Unum In Die Efficacy trial, HA hyaluronic acid, HCS the health care system, HMW high molecular weight, HSS hospital for special surgery, HUI Health Utility Index, JPY Japanese yen, KSS Knee Society Score, LMW low molecular weight, LYG life-year gained, MPCI minimal perceptible clinical improvement, NA not applicable, NHS National Health Service, NICE National Institute for Health and Care Excellence, NR not reported, NSAID non-steroidal anti-inflammatory drug, OA osteoarthritis, OAPol model Osteoarthritis Policy model, OROS osmotic-controlled release oral delivery system, OTC over-the-counter, PPI proton pump inhibitor, PRP platelet-rich plasma, PSA probabilistic sensitivity analysis, PUB perforation, ulcers and/or bleeding, QALY quality-adjusted life-year, QHES Quality of Health Economic Studies, SA sensitivity analysis, SEK Swedish kronor, SF-36 Short Form-36, SPI Sleep Problems Index, STOPP Study on Osteoarthritis Progression Prevention, THB Thai Baht, TKA total knee arthroplasty, TL Tegner/Lysholm, TOIB Topical or Oral Ibuprofen study, TSA threshold sensitivity analysis, TWD New Taiwan dollar, UCLA University of California Los Angeles, USD US dollars, VAS visual analog scale, WOMAC the Western Ontario McMaster University Osteoarthritis Index