Please use this identifier to cite or link to this item: https://doi.org/10.1111/1756-185X.13446
Title: COST-EFFECTIVENESS OF AN ADHERENCE-ENHANCING INTERVENTION FOR GOUT BASED ON REAL-WORLD DATA
Authors: Lin, LW 
Teng, GG 
Lim, AYN 
Yoong, JSY 
Zethraeus, N
Wee, HL 
Keywords: allopurinol
cost-effectiveness analysis
electronic medical records
gout
medication adherence
quality-adjusted life year
Issue Date: 1-Apr-2019
Publisher: Wiley
Citation: Lin, LW, Teng, GG, Lim, AYN, Yoong, JSY, Zethraeus, N, Wee, HL (2019-04-01). COST-EFFECTIVENESS OF AN ADHERENCE-ENHANCING INTERVENTION FOR GOUT BASED ON REAL-WORLD DATA 22 (4) : 545-554. ScholarBank@NUS Repository. https://doi.org/10.1111/1756-185X.13446
Abstract: © 2018 The Authors. International Journal of Rheumatic Diseases published by Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd. Aim: Medication non-adherence influences outcomes of therapies for chronic diseases. Allopurinol is a cornerstone therapy for patients with gout; however, non-adherence to allopurinol is prevalent in Singapore and limits its effectiveness. Between 2008-2010, an adherence-enhancing program was implemented at the rheumatology division of a public tertiary hospital. The cost-effectiveness of this program has not been fully evaluated. With healthcare resources being finite, the value of investing in adherence-enhancing interventions should be ascertained. This study aims to evaluate the cost-effectiveness of this adherence-enhancing program to inform optimal resource allocation toward better gout management. Method: Adopting a real-world data approach, we utilized patient clinical and financial records generated in their course of routine care. Intervention and control groups were identified in a standing database and matched on nine risk factors through propensity score matching. Cost and effect data were followed through 1-2 years. A decision tree was developed in TreeAge using a societal perspective. Deterministic and probabilistic sensitivity analyses were performed to assess parameter uncertainty. Results: At an assumed willingness-to-pay threshold of $50 000 USD ($70 000 SGD) per quality-adjusted life year (QALY), the intervention had an 85% probability of being cost-effective compared to routine care. The incremental cost-effectiveness ratio was $12 866 USD per QALY for the base case and ranged from $4 139 to $21 593 USD per QALY in sensitivity analyses. Conclusion: The intervention is cost-effective in the short-term, although its long-term cost-effectiveness remains to be evaluated.
URI: https://scholarbank.nus.edu.sg/handle/10635/155410
ISSN: 1756-1841
1756-185X
DOI: 10.1111/1756-185X.13446
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