Ronaldson, Sarah Jane orcid.org/0000-0001-8321-786X, Keding, Ada orcid.org/0000-0002-1182-887X, Tharmanathan, Puvanendran orcid.org/0000-0001-9196-0207 et al. (4 more authors) (2023) Cost-effectiveness of hydroxychloroquine versus placebo for hand osteoarthritis:economic evaluation of the HERO trial. F1000research. 821. ISSN 2046-1402
Abstract
Background: An economic evaluation alongside the Hydroxychloroquine Effectiveness in Reducing symptoms of hand Osteoarthritis (HERO) trial was undertaken to assess the cost-effectiveness of hydroxychloroquine compared with placebo for symptomatic treatment of hand osteoarthritis for patients with at least moderate hand pain and inadequate response to current therapies. Methods: A trial-based cost–utility analysis was undertaken from the perspective of the UK National Health Service and Personal Social Services over a 12-month time horizon, using evidence from 248 participants included in the HERO trial, conducted in England. Patient-level data were collected prospectively over a 12-month period, using participant-completed questionnaires and investigator forms, to collect healthcare utilisation, costs and quality-adjusted life years (QALYs) using the EQ-5D-5L. The base-case analysis was conducted on an intention-to-treat basis and used multiple imputation methods to deal with missing data. Results were presented in terms of incremental cost-effectiveness ratios (incremental cost per QALY) and net health benefit, with uncertainty surrounding the findings explored using cost-effectiveness acceptability curves. Results: The base-case analysis estimated slightly lower costs on average (−£11.80; 95% confidence interval (CI) −£15.60 to −£8.00) and marginally fewer QALYs (−0.0052; 95% CI −0.0057 to −0.0047) for participants in the hydroxychloroquine group versus placebo group at 12 months. The resulting incremental cost-effectiveness ratio of £2,267 per QALY lost indicated that although costs were saved, health-related quality of life was lost. Even assuming symmetrical preferences regarding losses and gains for health benefits, the findings do not fall within the cost-effective region. Similar findings arose for analyses conducted from the societal perspective and using complete cases only. Conclusions: This economic evaluation indicates that hydroxychloroquine is unlikely to provide a cost-effective pain relief option for improving health-related quality of life in adult patients with moderate-to-severe hand osteoarthritis. Keywords economic evaluation, hand osteoarthritis, hydroxychloroquine, randomised controlled trial, cost-effectiveness analysis, cost-utility analysis
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2021 Ronaldson SJ et al. |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Health Sciences (York) |
Depositing User: | Pure (York) |
Date Deposited: | 18 Aug 2021 08:50 |
Last Modified: | 18 Mar 2025 00:09 |
Published Version: | https://doi.org/10.12688/f1000research.55296.1 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.12688/f1000research.55296.1 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:177216 |
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Description: Cost-effectiveness of hydroxychloroquine versus placebo for hand osteoarthritis: economic evaluation of the HERO trial [version 1; peer review: awaiting peer review]
Licence: CC-BY 2.5
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Description: Cost-effectiveness of hydroxychloroquine versus placebo for hand osteoarthritis: economic evaluation of the HERO trial [version 1; peer review: 2 approved]
Licence: CC-BY 2.5