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PharmacoEconomics
Published in: PharmacoEconomics 3/2004

01-02-2004 | Original Research Article

Cost Effectiveness of Interventions for Lateral Epicondylitis

Results from a Randomised Controlled Trial in Primary Care

Authors: Ingeborg B. C. Korthals-de Bos, Nynke Smidt, Maurits W. van Tulder, Maureen P. M. H. Rutten-van Mölken, Herman J. Adèr, Daniëlle A. W. M. van der Windt, Willem J. J. Assendelft, Lex M. Bouter

Published in: PharmacoEconomics | Issue 3/2004

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Abstract

Objective: Lateral epicondylitis is a common complaint, with an annual incidence between 1% and 3% in the general population. The Dutch College of General Practitioners in The Netherlands has issued guidelines that recommend a wait-and-see policy. However, these guidelines are not evidence based.
Design and setting: This paper presents the results of an economic evaluation in conjunction with a randomised controlled trial to evaluate the effects of three interventions in primary care for patients with lateral epicondylitis.
Patients and interventions: Patients with pain at the lateral side of the elbow were randomised to one of three interventions: a wait-and-see policy, corticosteroid injections or physiotherapy.
Main outcome measures and results: Clinical outcomes included general improvement, pain during the day, elbow disability and QOL. The economic evaluation was conducted from a societal perspective. Direct and indirect costs (in 1999 values) were measured by means of cost diaries over a period of 12 months. Differences in mean costs between groups were evaluated by applying non-parametric bootstrap techniques. The mean total costs per patient for corticosteroid injections were €430, compared with €631 for the wait-and-see policy and €921 for physiotherapy. After 12 months, the success rate in the physiotherapy group (91%) was significantly higher than in the injection group (69%), but only slightly higher than in the wait-and-see group (83%). The differences in costs and effects showed no dominance for any of the three groups. The incremental costutility ratios were (approximately): €7000 per utility gain for the wait-and-see policy versus corticosteroid injections; €12 000 per utility gain for physiotherapy versus corticosteroid injections, and €34 500 for physiotherapy versus the waitand- see policy.
Conclusions: The results of this economic evaluation provided no reason to update or amend the Dutch guidelines for GPs, which recommend a wait-and-see policy for patients with lateral epicondylitis.
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Metadata
Title
Cost Effectiveness of Interventions for Lateral Epicondylitis
Results from a Randomised Controlled Trial in Primary Care
Authors
Ingeborg B. C. Korthals-de Bos
Nynke Smidt
Maurits W. van Tulder
Maureen P. M. H. Rutten-van Mölken
Herman J. Adèr
Daniëlle A. W. M. van der Windt
Willem J. J. Assendelft
Lex M. Bouter
Publication date
01-02-2004
Publisher
Springer International Publishing
Published in
PharmacoEconomics / Issue 3/2004
Print ISSN: 1170-7690
Electronic ISSN: 1179-2027
DOI
https://doi.org/10.2165/00019053-200422030-00004

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