Cost effectiveness of combined spa-exercise therapy in ankylosing spondylitis: a randomized controlled trial.

摘要: Objective To evaluate the cost effectiveness and utility of a 3-week course combined spa therapy exercise in addition to standard treatment consisting antiinflammatory drugs weekly group physical ankylosing spondylitis (AS) patients. Methods A total 120 Dutch outpatients with AS were randomly allocated into 3 groups 40 patients each. Group 1 was treated resort Bad Hofgastein, Austria; 2 Arcen, The Netherlands. control stayed at home continued their usual activities during intervention weeks. After intervention, all followed therapy. study period Effectiveness assessed by functional ability using Bath Ankylosing Spondylitis Function Index (BASFI). Utilities measured EuroQoL (EQ-5Dutility). A time-integrated summary score defined clinical effects (BASFI-area under curve [AUC]) utilities (EQ-5Dutility-AUC) over time. Both direct (health care non-health care) indirect costs included. Resource utilization absence from work registered diary. All calculated societal perspective. Results A 111 completed between-group difference for BASFI-AUC 1.0 (95% confidence interval [95% CI] 0.4–1.6; P = 0.001) versus controls, 0.6 CI 0.1–1.1; 0.020) controls. EQ-5Dutility-AUC 0.17 0.09–0.25; < 0.08 0.00–0.15; 0.04) mean per patient (including therapy) Euros (€) €3,023 1, €3,240 2, €1,754 group. incremental cost-effectiveness ratio unit effect gained (0–10 scale) €1,269 497–3,316) €2,477 601–12,098) 2. quality-adjusted life year €7,465 3,294–14,686) €18,575 3,678–114,257) 2. Conclusion Combined spa–exercise besides is more effective shows favorable cost-utility ratios compared alone AS.