CE1 COST-EFFECTIVENESS ANALYSIS OF GLUCOSAMINE SULPHATE FOR THE TREATMENT OF OSTEOARTHRITIS IN THAILAND

Abstract

OBJECTIVES: Recent evidences have shown that glucosamine sulphate (GS) is a potentially effective treatment for osteoarthritis; however, it is unclear whether its use is cost-effective from the perspective of Thai Ministry of Public Health (MOPH). This study aims to estimate the cost-effectiveness of glucosamine sulphate (GS) compared with current care (CC) in osteoarthritis (OA) patients in Thailand. METHODS: A Markov model was used to simulate 10,000 hypothetical OA cohorts. The model comprised four health states including OA without total knee replacement (TKR), OA with TKR, OA after TKR, and death. Transition probabilities and health state utilities were obtained from published literature. Drug cost was obtained from the Drugs and Medical Supplies Information Center, MOPH, while the cost of TKR was based on the reimbursement rate provided by National Health Security Office. The model estimated quality-adjusted life-years (QALYs), costs and incremental cost-effectiveness ratio (Cost/QALY gained) over life time horizon. Probabilistic sensitivity analyses (PSA) were undertaken. Both cost and health outcomes were discounted at 3%. RESULTS: The estimated QALYs were 17.88 and 17.79 QALYs for GS and CC, respectively. The lifetime direct medical costs for GS (generic brand), GS (original brand) and CC were 123,679 THB, 279,988 THB, and 57,863 THB, respectively. Compared to CC, the incremental cost per QALYs gained was 774,125 THB/QALY for GS generic brand and 2,612,605 THB/QALY for GS original brand. Based on a cost-effectiveness cut-off of 100,000 and 300,000 THB/QALY, the probability that GS (generic brand) being cost-effective was 38.6% and 50.0%, respectively. Using GS generic brand would be cost-effective if the GS price is lowered about two-thirds of the current price. CONCLUSIONS: Using GS in OA patients may not be cost-effective from the perspective of Thai Ministry of Public Health. Policymakers may consider using such value for money information for aiding policy decision-making.