Center for Health Economics and Health Services Research, University of Wuppertal, Wuppertal, Germany.
Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany.
Haemophilia. 2018 May;24(3):385-394. doi: 10.1111/hae.13459. Epub 2018 Mar 30.
Recurrent musculoskeletal haemorrhages in people with haemophilia (PwH) lead to restrictions in the locomotor system and, as a result, in physical performance, too. Due to its physical and psychological benefits, sport is increasingly re-commended for haemophilic patients. Evidence on the cost-effectiveness of sports therapy is still lacking.
The aim of this study was to determine the cost-effectiveness of a 6-month programmed sports therapy (PST).
The cost-effectiveness of the 6-month PST was assessed from a societal perspective alongside a RCT using cost-utility analysis. The analysis included 50 PwH with moderate-to-severe haemophilia A and B and a training period over 6 months. The health-related quality of life was measured with the EuroQoL-domain questionnaire. Resource utilization was assessed by questionnaire before and after the intervention. A cost-effectiveness acceptability curve was constructed, and sensitivity analyses were performed.
During the 6-month study period, mean adjusted total healthcare costs were lower (mean difference: -22 805 EUR; 95%-CI: -73 944-48 463; P = .59) and the number of QALYs was higher in the intervention group (mean difference: 0.3733; 95%-CI: 0.0014-0.0573; P = .04). The probability of an incremental cost-effectiveness ratio <50 000 EUR per QALY was 71%. The performed sensitivity analysis confirmed these results.
Results showed that the PST is effective in terms of a significant gain of QALYs. Furthermore, results weakly indicate the potential of the PST to reduce healthcare costs. Future studies should expand the observation period to have a closer look at the influence of PST on lifetime costs.
患有血友病(PwH)的人会反复出现肌肉骨骼出血,这会导致运动系统受限,进而影响身体机能。由于运动具有生理和心理上的益处,因此越来越多的血友病患者被建议参加运动。但目前仍缺乏有关运动疗法成本效益的证据。
本研究旨在确定 6 个月程序化运动疗法(PST)的成本效益。
采用 RCT 联合成本效用分析,从社会角度评估 6 个月 PST 的成本效益。该分析纳入了 50 名患有中重度血友病 A 和 B 的 PwH,并进行了为期 6 个月的训练。使用 EuroQoL 量表评估健康相关生活质量。干预前后通过问卷评估资源利用情况。构建成本效益接受曲线,并进行敏感性分析。
在 6 个月的研究期间,干预组的平均调整后总医疗保健成本较低(平均差异:-22805 欧元;95%CI:-73944-48463;P=0.59),且 QALY 更高(平均差异:0.3733;95%CI:0.0014-0.0573;P=0.04)。增量成本效益比低于 50000 欧元/QALY 的概率为 71%。敏感性分析结果证实了这些结果。
结果表明,PST 在提高 QALY 方面具有显著效果。此外,结果还表明 PST 有潜力降低医疗保健成本。未来的研究应延长观察期,以更深入地了解 PST 对终生成本的影响。