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Abstract

Objective: To comprehensively synthesise the evolution of health-economic evaluation models (HEEMs) of all OA interventions including preventions, core treatments, adjunct non-pharmacological interventions, pharmacological and surgical treatments.Methods: The literature was searched within health-economic/biomedical databases. Data extracted included: OA type, population characteristics, model setting/type/events, study perspective, comparators; and the reporting quality of the studies was assessed. The review protocol was registered at the International Prospective Register of Systematic Reviews (registration: CRD42018092937).Results: Eighty-eight studies were included. Pharmacological and surgical interventions were the focus in 51% and 44% studies, respectively. Twenty-four studies adopted a societal perspective (with increasing popularity after 2013), however most (63%) did not include indirect costs. Quality-adjusted life years (QALYs) was the most popular outcome measure since 2008. Markov models were used by 62% of studies, with increasing popularity since 2008. Until 2010, most studies used short-to-medium time horizons; subsequently a lifetime horizon became popular. Eighty-six percent of studies reported discount rate(s) (predominantly between 3% and 5%). Studies published after 2002 had a better coverage of OA-related adverse events (AEs). Reporting quality significantly improved after 2001.Conclusions: OA HEEMs have evolved and improved substantially over time, with focus shifting from short-to-medium-term pharmacological decision-tree models to surgical-focused lifetime Markov models. Indirect costs of OA are frequently not considered, despite using a societal perspective. There was lack of reporting sensitivity of model outcome to input parameters including discount rate, OA definition, and population parameters. Whilst the coverage of OA-related AEs has improved over time, it is still not comprehensive.

Item Type:	Article
Authors/Creators:	Zhao, T and Ahmad, H and de Graaff, B and Xia, Q and Winzenberg, T and Aitken, D and Palmer, AJ
Keywords:	systematic review, health economic models, osteoarthritis, health-economic evaluation, Markov models, decision-tree models
Journal or Publication Title:	Arthritis Care & Research
Publisher:	John Wiley & Sons, Inc.
ISSN:	2151-464X
DOI / ID Number:	10.1002/acr.24410
Copyright Information:	"This is the peer reviewed version of the following article: A Systematic Review of the Evolution of Health‐Economic Evaluation Models of Osteoarthritis, which has been published in final form at https://doi.org/10.1002/acr.24410. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions."
Related URLs:	Google Scholar: Winzenberg, T UTAS Profile: Winzenberg, T Google Scholar: Aitken, D UTAS Profile: Aitken, D UTAS Profile: Palmer, AJ
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