COST-EFFECTIVENESS OF THE ARTHRITIS SELF-HELP COURSE

Objective: To evaluate the cost-effectiveness of the Arthritis Self-He lp Course in reducing the pain of arthritis, the leading cause of disa bility in the United States and a common problem among older adults. M ethods: A decision model was used to examine the cost-effectiveness of the Arthritis Self-Help Course among individuals with arthritis over a 4-year analytic horizon from 2 perspectives, namely, society and the health care system. The Arthritis Self-Help Course was assumed to red uce pain by 20% and physician visits for arthritis by 40% among indivi duals receiving conventional medical therapy. Estimates for program co sts, costs for physician visits, and time and transportation costs wer e derived from the published literature and expert opinion. Sensitivit y analyses were conducted on all relevant parameters. Arthritis pain a nd costs (program, physician visit plus/minus time and transportation) were expressed as cost per person per unit reduction in pain. Because nearly all analyses showed the program to be cost saving, we simply r eport the reduction in joint pain and the cost savings, because standa rdizing cost savings is not a useful concept. Results: From both the s ocietal and health care system perspectives, the Arthritis Self-Help C ourse was cost saving in base-case analyses (reducing pain by 0.9 unit s while saving $320 and $267, respectively) and throughout the range o f reasonable values used in univariate sensitivity analyses. Cost savi ngs were due primarily to reduced physician visits. Conclusions: The A rthritis Self-Help Course is a cost-saving intervention that further r educes arthritis pain among individuals receiving conventional medical therapy. The benefits for both patients and health care providers war rant its more widespread use as a normal adjunct to conventional thera py.