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Cost-effectiveness of yoga vs. strengthening exercise for treating knee OA: Evidence from a randomized controlled
Bedru J Abafita1, Ambrish Singh1, Dawn Aitken1
1Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia.
Objective:
This study aims to evaluate the cost-effectiveness of yoga vs. strengthening exercise for people with knee OA.
Methods:
A cost-utility analysis was conducted alongside a randomized controlled trial. Participants with symptomatic knee OA were randomized to 12 weeks of yoga or strengthening exercise. Costs were assessed from both societal and healthcare perspectives, including healthcare utilization, intervention delivery, medications, equipment, transport, and productivity losses. Health-related quality of life was measured using the EQ-5D-5L to calculate quality-adjusted life years (QALYs). Incremental costs and effects were estimated using seemingly unrelated regression with multiple imputation. The primary outcome was the incremental cost-effectiveness of the two interventions. Uncertainty was assessed through bootstrapping, and cost-effectiveness acceptability curves were generated.
Results:
A total of 117 participants (mean age 62.5 years; 73% female) were randomized to yoga (n = 58) or strengthening exercises (n = 59). Over 3 months, yoga was associated with slightly lower societal costs (mean difference AUD$-129.1 (95% CI -257.3 to -0.8) and marginally higher QALYs (0.004, 95% CI -0.01 to 0.02). Results were similar from the healthcare perspective (cost difference AUD$-97.6; 95% CI -140.5 to -54.8). The probability that yoga was cost-effective at a willingness-to-pay threshold (WTP) of AUD$50,000 per QALY was 79% from a societal perspective and 77% from a healthcare perspective.
Conclusion:
A 3-month yoga program for knee OA was non-inferior to strengthening exercise and is likely to be cost-effective. Longer-term studies are needed to confirm sustainability and broader value. We anticipate that these findings will contribute further insights and add to the evidence base regarding the potential role of yoga as an alternative exercise modality in clinical practice for the management of knee OA.
