Table 2.
Lifetime QALYs, costs, and net monetary benefits per capita and incremental cost-effectiveness ratios.
|
Intervention |
Incremental QALYsa | Incremental Costsa | INMB at WTP threshold:a |
ICERb | ICER (excl. walking cane)b | ||
|---|---|---|---|---|---|---|---|
| 1x GDP per capita | 2x GDP per capita | 3x GDP per capita | |||||
| Walking cane | 0.033 (0.002–0.081) | −$115 (−280 to −28) | $1 861 (153–4 544) | $3 606 (282–8 798) | $5 352 (410–13 058) | C–S | – |
| Oral NSAIDs | −0.004 (−0.010 to 0.002) | −$87 (−137 to −42) | −$111 (−395 to 150) | −$309 (−915 to 248) | −$506 (−1 434 to 346) | Dom | $22 956c |
| Heat therapy | 0.007 (−0.004 to 0.027) | −$41 (−93 to 5) | $426 (−178 to 1 502) | $811 (−375 to 2 903) | $1 196 (−572 to 4 333) | Dom | $4 064 |
| Aquatic exercise | 0.012 (0.007–0.017) | $213 (96–364) | $393 (98–706) | $999 (478–1 581) | $1 605 (840–2 451) | Dom | ED |
| Topical NSAIDs | 0.006 (0.003–0.009) | $393 (137–737) | −$75 (−434 to 230) | $243 (−202 to 672) | $561 (−11 to 1 159) | Dom | Dom |
| CBT | 0.003 (−0.027 to 0.034) | $515 (−5 to 1 347) | −$334 (−2 224 to 1 409) | −$154 (−3 558 to 3 097) | $27 (−4 876 to 4 784) | Dom | Dom |
| Intra-articular corticosteroids | 0.023 (0.004–0.043) | $564 (380–739) | $628 (−384 to 1 706) | $1 820 (−176 to 3 976) | $3 012 (18–6 256) | Dom | $39 251 |
| Duloxetine | 0.003 (−0.000 to 0.006) | $632 (470–832) | −$482 (−694 to −291) | −$333 (−648 to −1) | −$183 (−640 to 312) | Dom | Dom |
| Massage therapy | 0.008 (−0.012 to 0.031) | $4 127 (881–9 657) | −$3 714 (−9 238 to −406) | −$3 301 (−8 854 to 463) | −$2 887 (−8 842 to 1 674) | Dom | Dom |
Cells report lifetime per-capita outcomes (90% uncertainty interval), for the 2013 NZ adult population. Uncertainty intervals calculated as the 5th and 95th percentile of outcomes from the 1000 probabilistic sensitivity analysis model runs.
C–S: Cost-saving and greater QALYs (compared to core treatments only); Dom: Dominated by previous (non-dominated) intervention; ED: Extendedly-dominated (lower QALYs and higher costs than a combination of other interventions). CBT: Cognitive behavioural therapy; NSAIDs: Non-steroidal anti-inflammatory drugs. GDP: Gross Domestic Product, 2013 NZD; ICER: Incremental Cost-Effectiveness Ratio; INMB: Incremental Net Monetary Benefit, calculated at 1, 2, and 3 times GDP per capita willingness to pay levels; QALY: Quality-adjusted life year; WTP: willingness-to-pay threshold per QALY gained.
Compared to core treatments only comparator.
Compared to next-highest-cost non-dominated treatment.
Cost-saving but lower QALYs, not cost-effective compared to core treatments only.