Cost-utility of a six-month programmed sports therapy (PST) in patients with haemophilia

Haemophilia. 2018 May;24(3):385-394. doi: 10.1111/hae.13459. Epub 2018 Mar 30.

Abstract

Introduction: Recurrent musculoskeletal haemorrhages in people with haemophilia (PwH) lead to restrictions in the locomotor system and, as a result, in physical performance, too. Due to its physical and psychological benefits, sport is increasingly re-commended for haemophilic patients. Evidence on the cost-effectiveness of sports therapy is still lacking.

Aim: The aim of this study was to determine the cost-effectiveness of a 6-month programmed sports therapy (PST).

Methods: The cost-effectiveness of the 6-month PST was assessed from a societal perspective alongside a RCT using cost-utility analysis. The analysis included 50 PwH with moderate-to-severe haemophilia A and B and a training period over 6 months. The health-related quality of life was measured with the EuroQoL-domain questionnaire. Resource utilization was assessed by questionnaire before and after the intervention. A cost-effectiveness acceptability curve was constructed, and sensitivity analyses were performed.

Results: During the 6-month study period, mean adjusted total healthcare costs were lower (mean difference: -22 805 EUR; 95%-CI: -73 944-48 463; P = .59) and the number of QALYs was higher in the intervention group (mean difference: 0.3733; 95%-CI: 0.0014-0.0573; P = .04). The probability of an incremental cost-effectiveness ratio <50 000 EUR per QALY was 71%. The performed sensitivity analysis confirmed these results.

Conclusion: Results showed that the PST is effective in terms of a significant gain of QALYs. Furthermore, results weakly indicate the potential of the PST to reduce healthcare costs. Future studies should expand the observation period to have a closer look at the influence of PST on lifetime costs.

Keywords: HRQoL; Intervention; cost-effectiveness; cost-utility analysis; haemophilia; training.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cost-Benefit Analysis*
  • Exercise Therapy / economics*
  • Female
  • Hemophilia A / therapy*
  • Humans
  • Male
  • Quality-Adjusted Life Years
  • Sports*