Cost-effectiveness of cognitive behavioural and personalized exercise interventions for reducing fatigue in inflammatory rheumatic diseases
Authors' conclusion
The addition of a PEP alongside UC is likely to provide a cost-effective use of health care resources.
Study context
- Population
- Patients with inflammatory rheumatic diseases reporting chronic, moderate to severe fatigue
- Comparison
- Cognitive behavioural approach (CBA) or personalized exercise programme (PEP) alongside usual care (UC) vs UC
- Primary endpoint
- Cost-effectiveness (cost per QALY gained), UK NHS perspective
- Follow-up
- 56 weeks
Methodological detailsmulticentre, three-arm, 56-week, UK National Health Service (NHS) perspective, cost-effectiveness acceptability curves, sensitivity analysis
- Multicentre
- Three-arm
- 56-week
- UK NHS perspective
- Cost-effectiveness acceptability curves
- Sensitivity analysis
Primary result
As reported in the abstract
Adjusted mean cost and QALY differences and ICER vs UC (complete-case analysis)
- PEP
- adjusted mean cost difference 569 £ (95% CI £464, £665)
- CBA
- adjusted mean cost difference 845 £ (95% CI £717, £993)
- PEP · significantly more effective
- adjusted mean quality-adjusted life year (QALY) difference 0.043 QALY (95% CI 0.019–0.068)
- CBA
- adjusted mean QALY difference 0.001 QALY (95% CI −0.022 to 0.022)
- PEP
- Incremental cost-effectiveness ratio (ICER) 13 159 £
- CBA
- ICER 793 777 £
- Probability PEP cost-effective at £20 000 per QALY gained (non-parametric bootstrapping)
- 88%
Further findings
| Outcome | Estimate |
|---|---|
| PEP vs UC, multiple imputation analysisPEP vs UC · significant · multiple imputation analysis | incremental costs 428 £ (95% CI £324, £511) |
| PEP vs UC, multiple imputation analysisPEP vs UC · non-significant · multiple imputation analysis | QALY gain 0.016 QALY (95% CI −0.003 to 0.035) |
| PEP vs UC, multiple imputation analysisPEP vs UC · multiple imputation analysis | ICER 26 822 £ |
Sensitivity analyses
- Estimates consistent with main results
Original publication
Cost-effectiveness of cognitive behavioural and personalized exercise interventions for reducing fatigue in inflammatory rheumatic diseases. Rheumatology (Oxford). Published 5 April 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →