Abstract
BackgroundThe economic evaluation of treatments usually requires access to individual patient data, which is difficult to obtain. Moreover, in osteoarthritis, health utility scores are unavailable and can be assessed only using a validated equation model based on various clinical data. We aimed to develop and validate a methodology to simulate individual health utility scores from aggregated clinical data available in published studies to calculate the cost-effectiveness of different glucosamine preparations (i.e., crystalline glucosamine sulfate, glucosamine sulfate, and glucosamine hydrochloride) used for osteoarthritis.MethodsWe developed a method to simulate individual utility values and validated the model by comparing the results obtained with the simulation and the results of one trial where the utility scores are available. Then, we simulated the utility scores of 10 published trials that used different glucosamine preparations. The utility estimates were used to calculate the quality-adjusted life year (QALY) using the area-under-the-curve method. Costs were for the glucosamine product only. The incremental cost/effectiveness ratio (ICER) was then calculated.ResultsThe values of utility scores calculated from data sources and those simulated with the model were similar. From 10 studies where utility was simulated, four used crystalline glucosamine sulfate, and six used other formulations. The ICER revealed that compared to placebo, crystalline glucosamine sulfate only was cost-effective at all time points and up to 3 years with a median ICER of 5347.2 €/QALY at month 3, 4807.2 €/QALY at month 6 and 11535.5 €/QALY at year 3. The use of other formulations was not cost-effective.ConclusionUsing a new model to simulate individual health utility scores of patients included in ten published trials, ICER analysis showed that the use of crystalline glucosamine sulfate is cost-effective, while other formulations were not. The results confirm the importance of the formulation of glucosamine products.
Highlights
Osteoarthritis (OA) is a major public health problem because of its current and future prevalence, its impact on mortality and morbidity and the associated healthcare cost [1]
Multiple formulations of glucosamine and chondroitin are available as both prescription-grade products and nutritional supplements, and these differences have been hypothesised as being an important driver of the discrepancy in the level of recommendation of SYSADOAS between guidelines [7]
With glucosamine, an independent metaanalysis has shown that in trials using a specific formulation of glucosamine, the prescription crystalline glucosamine sulfate had a better outcome on pain than did other preparations of glucosamine [9]
Summary
Osteoarthritis (OA) is a major public health problem because of its current and future prevalence, its impact on mortality and morbidity and the associated healthcare cost [1]. Multiple formulations of glucosamine and chondroitin are available as both prescription-grade products and nutritional supplements, and these differences have been hypothesised as being an important driver of the discrepancy in the level of recommendation of SYSADOAS between guidelines [7]. In osteoarthritis, health utility scores are unavailable and can be assessed only using a validated equation model based on various clinical data. We aimed to develop and validate a methodology to simulate individual health utility scores from aggregated clinical data available in published studies to calculate the cost-effectiveness of different glucosamine preparations (i.e., crystalline glucosamine sulfate, glucosamine sulfate, and glucosamine hydrochloride) used for osteoarthritis. Conclusion Using a new model to simulate individual health utility scores of patients included in ten published trials, ICER analysis showed that the use of crystalline glucosamine sulfate is cost-effective, while other formulations were not.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
