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Evidence-Based Medicine Is Affordable: The Cost-Effectiveness of Current Compared with Optimal Treatment in Rheumatoid and Osteoarthritis

Citation

Andrews, G and Simonella, L and Lapsley, H and Sanderson, Kristy and March, L, Evidence-Based Medicine Is Affordable: The Cost-Effectiveness of Current Compared with Optimal Treatment in Rheumatoid and Osteoarthritis, Journal of Rheumatology, 33, (4) pp. 671-680. ISSN 0315-162X (2006) [Refereed Article]

Abstract

Objective. To determine the cost-effectiveness of averting the burden of disease. We used secondary population data and metaanalyses of various government-funded services and interventions to investigate the costs and benefits of various levels of treatment for rheumatoid arthritis (RA) and osteoarthritis (OA) in adults using a burden of disease framework. Method. Population burden was calculated for both diseases in the absence of any treatment as years lived with disability (YLD), ignoring the years of life lost. We then estimated the proportion of burden averted with current interventions, the proportion that could be averted with optimally implemented current evidence-based guidelines, and the direct treatment cost-effectiveness ratio in dollars per YLD averted for both treatment levels. Results. The majority of people with arthritis sought medical treatment. Current treatment for RA averted 26% of the burden, with a cost-effectiveness ratio of $ 19,000 per YLD averted. Optimal, evidence-based treatment would avert 48% of the burden, with a cost-effectiveness ratio of $ 12,000 per YLD averted. Current treatment of OA in Australia averted 27% of the burden, with a cost-effectiveness ratio of $25,000 per YLD averted. Optimal, evidence-based treatment would avert 39% of the burden, with an unchanged cost-effectiveness ratio of $25,000 per YLD averted. Conclusion. While the precise dollar costs in each country will differ, the relativities at this level of coverage should remain the same. There is no evidence that closing the gap between evidence and practice would result in a drop in efficiency.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Rheumatology and Arthritis
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Skeletal System and Disorders (incl. Arthritis)
Author:Sanderson, Kristy (Associate Professor Kristy Sanderson)
ID Code:43048
Year Published:2006
Web of Science® Times Cited:13
Deposited By:Menzies Institute for Medical Research
Deposited On:2007-10-05
Last Modified:2007-10-05
Downloads:0

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