Abstract
To assess quality of life (QoL), costs, and cost-effectiveness of acupuncture treatment plus routine care versus routine care alone in osteoarthritis patients, a randomised, controlled trial was conducted in 255 general practices in Germany. Four hundred and eighty-nine patients with chronic pain due to osteoarthritis of the knee or hip were included to evaluated QoL and costs at baseline and after 3 months using health insurance funds data and standardized questionnaires. Patients receiving acupuncture had an improved QoL associated with significantly higher costs over the 3 months treatment period compared to routine care alone (mean cost-difference: €469.50 [95%CI €135.80–€803.19]). This increase in costs was primarily due to the costs of acupuncture. The overall ICER was €17,845 per QALY gained. The degree of cost-effectiveness was influenced by gender, with female patients achieving a better cost-effectiveness ratio than men. In conclusion, acupuncture was a cost-effective treatment strategy in patients with chronic osteoarthritis pain.
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Acknowledgments
We would like to thank Katja Wruck for data management, Iris Bartsch and Beatrice Eden for data acquisition, the members of the advisory board (Dr. Bodo Liecker, Dr. Konrad Beyer, Dr. Josef Hummelsberger, Hardy Müller, Dr. Albrecht Molsberger, Dr. Helmut Rüdinger, Dr. Wolfram Stör, Dr. Gabriel Stux) for helpful advice and Niels Balthasar and Jürgen Schwabe for health economic data management. In addition, we would like to express our gratitude to all participating patients and physicians. Conflict of interest: All authors declare that they had no conflict of interest. Competing Interests: Funding: Study activities were funded by the following German social health insurance funds: Techniker Krankenkasse (TK); BKK Aktiv; Betriebskrankenkasse der Allianz Gesellschaften; Bertelsmann BKK; Bosch BKK; BKK BMW; DaimlerChrysler BKK; BKK Deutsche Bank; Ford Betriebskrankenkasse; BKK Hoechst; HypoVereinsbank Betriebskrankenkasse; Siemens-Betriebskrankenkasse; Handelskrankenkasse; Innungskrankenkasse Hamburg. Role of the Funding Source: The trial was initiated at the request of the German health authorities (Federal Committee of Physicians and Social Health Insurance Companies, German Federal Social Insurance Authority) and sponsored by a number of German Social Health Insurance companies. All decisions on design, data collection, analysis, interpretation, and publication were left completely to discretion of the researchers. Authors’ Contributions: All authors participated in planning the protocol and revising the drafts of the manuscript. Specific tasks and responsibilities: general trial coordination (CMW, SJ, DS), statistical analysis and economic expertise (TR, DS, SJ, CMW, SNW), overall medical and scientific responsibility (SNW).
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Reinhold, T., Witt, C.M., Jena, S. et al. Quality of life and cost-effectiveness of acupuncture treatment in patients with osteoarthritis pain. Eur J Health Econ 9, 209–219 (2008). https://doi.org/10.1007/s10198-007-0062-5
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DOI: https://doi.org/10.1007/s10198-007-0062-5