The cost-effectiveness of guideline-recommended treatments for osteoarthritis: A systematic review
Authors' conclusion
There was a diversity of analytical perspectives and clinical heterogeneity of interventions.
Study context
- Population
- Studies providing incremental cost-effectiveness ratios (ICERs) for treatments recommended by key international guidelines to manage osteoarthritis (OA) in adults110 studies
- Participants
- 33 / 25 / 11 / 42
- Comparison
- Guideline-recommended OA treatments vs comparators
- Lifestyle and rehabilitative therapiesn = 33
- Pharmacologicaln = 25
- Injectionn = 11
- Surgicaln = 42
- Outcome
- ICERs, converted to 2023 US dollars
Methodological detailsrisk of bias assessed with CHEC checklist (trials) and Drummond checklist (modelling studies), ICERs converted to 2023 US dollars, cost-effectiveness judged against country-specific thresholds per QALY, Most studies (95%) conducted in high-income countries, Time horizons 8 weeks to a lifetime, Risk of bias domains frequently scored poorly for cost methods
- Risk of bias assessed with CHEC checklist (trials) and Drummond checklist (modelling studies)
- ICERs converted to 2023 US dollars
- Cost-effectiveness judged against country-specific thresholds per QALY
- Most studies (95%) conducted in high-income countries
- Time horizons 8 weeks to a lifetime
- Risk of bias domains frequently scored poorly for cost methods
Pooled result
As reported in the abstract
Cost-effectiveness (ICERs)
- Lifestyle and rehabilitative therapies and non-steroidal anti-inflammatory drugs (NSAIDs): cost-effectiveness mixed
- Hyaluronic acid injection cost-effective in knee OA vs placebo, usual care and paracetamol, but not vs corticosteroid injections and NSAIDs
- Total hip or knee replacement cost-effective vs usual care or no surgery; early access to replacement cost-effective vs delaying surgery
Original publication
The cost-effectiveness of guideline-recommended treatments for osteoarthritis: A systematic review. Osteoarthritis Cartilage. Published 15 April 2025. doi:10.
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