Related Experiment Video
Updated: Apr 25, 2026
Author Spotlight: Implementation of BIVA for Analyzing Disease Risk Factors in Patients with Low Body Cell Mass
Published on: July 14, 2023
Economic evaluation of a brief education, self-management and upper limb exercise training in people with rheumatoid
Victoria L Manning1, Billingsley Kaambwa1, Julie Ratcliffe1
1Division of Health and Social Care Research, King's College London, London, UK, Flinders Health Economics Group, Flinders University, Adelaide, Australia, Department of Rheumatology, King's College London, London, Cardiff Institute of Infection and Immunity, Cardiff University, Cardiff and Faculty of Health and Social Care Sciences, St George's University of London and Kingston University, London, UK.
Objective:
The aim of this study was to conduct a cost-utility analysis of the Education, Self-management and Upper Limb Exercise Training in People with RA (EXTRA) programme compared with usual care.
Methods:
A within-trial incremental cost-utility analysis was conducted with 108 participants randomized to either the EXTRA programme (n = 52) or usual care (n = 56). A health care perspective was assumed for the primary analysis with a 36 week follow-up. Resource use information was collected on interventions, medication, primary and secondary care contacts, private health care and social care costs. Quality-adjusted life years (QALYs) were calculated from the EuroQol five-dimension three-level (EQ-5D-3L) questionnaire responses at baseline, 12 and 36 weeks.
Results:
Compared with usual care, total QALYs gained were higher in the EXTRA programme, leading to an increase of 0.0296 QALYs. The mean National Health Service (NHS) costs per participant were slightly higher in the EXTRA programme (by £82), resulting in an incremental cost-effectiveness ratio of £2770 per additional QALY gained. Thus the EXTRA programme was cost effective from an NHS perspective when assessed against the threshold of £20 000-£30 000/QALY gained. Overall, costs were lower in the EXTRA programme compared with usual care, suggesting it was the dominant treatment option from a societal perspective. At a willingness-to-pay of £20 000/QALY gained, there was a 65% probability that the EXTRA programme was the most cost-effective option. These results were robust to sensitivity analyses accounting for missing data, changing the cost perspective and removing cost outliers.
Conclusion:
The physiotherapist-led EXTRA programme represents a cost-effective use of resources compared with usual care and leads to lower health care costs and work absence.
Trial Registration:
International Standard Randomized Controlled Trial Number Register; http://www.controlled-trials.com/isrctn/ (ISRCTN14268051).
More Related Videos
04:50Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
Published on: May 16, 2025
04:49Author Spotlight: Enhancing Post-Stroke Upper Limb Rehabilitation with Robotic Technologies for Improved Motor Recovery and Functional Outcomes
Published on: September 6, 2024
Related Concept Videos
01:21Rheumatic Heart Disease III: Medical Management
01:20Rheumatic Heart Disease IV: Nursing Management