Budget impact of the Walk With Ease program for knee osteoarthritis.

Autor:	Kumara MT; Policy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA., Cleveland RJ; Thurston Arthritis Research Center, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Kostic AM; Policy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA., Weisner SE; Thurston Arthritis Research Center, Osteoarthritis Action Alliance, University of North Carolina, Chapel Hill, NC, USA., Allen KD; Durham VA Health Care System, Durham, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Golightly YM; College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA.; Thurston Arthritis Research Center and Osteoarthritis Action Alliance, University of North Carolina, Chapel Hill, NC, USA., Welch H; Montana Department of Public Health and Human Services, Helena, MT, USA., Dale M; Montana Department of Public Health and Human Services, Helena, MT, USA., Messier SP; Department of Health and Exercise Science, Wake Forest University, Salem, NC, USA., Hunter DJ; Sydney Musculoskeletal Health, Kolling Institute, University of Sydney and Rheumatology Department, Royal North Shore Hospital, Sydney, Australia., Katz JN; Policy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA., Callahan LF; Thurston Arthritis Research Center, Departments of Medicine and Orthopaedics, Osteoarthritis Action Alliance, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA., Losina E; Policy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	Osteoarthritis and cartilage open [Osteoarthr Cartil Open] 2024 Mar 19; Vol. 6 (2), pp. 100463. Date of Electronic Publication: 2024 Mar 19 (Print Publication: 2024).
DOI:	10.1016/j.ocarto.2024.100463
Abstrakt:	Objective: Walk With Ease (WWE) is an effective low-cost walking program. We estimated the budget impact of implementing WWE in persons with knee osteoarthritis (OA) as a measure of affordability that can inform payers' funding decisions. Methods: We estimated changes in two-year healthcare costs with and without WWE. We used the Osteoarthritis Policy (OAPol) Model to estimate per-person medical expenditures. We estimated total and per-member-per-month (PMPM) costs of funding WWE for a hypothetical insurance plan with 75,000 members under two conditions: 1) all individuals aged 45+ with knee OA eligible for WWE, and 2) inactive and insufficiently active individuals aged 45+ with knee OA eligible. In sensitivity analyses, we varied WWE cost and efficacy and considered productivity costs. Results: With eligibility unrestricted by activity level, implementing WWE results in an additional $1,002,408 to the insurance plan over two years ($0.56 PMPM). With eligibility restricted to inactive and insufficiently active individuals, funding WWE results in an additional $571,931 over two years ($0.32 PMPM). In sensitivity analyses, when per-person costs of $10 to $1000 were added with 10-50% decreases in failure rate (enhanced sustainability of WWE benefits), two-year budget impact varied from $242,684 to $6,985,674 with unrestricted eligibility and from -$43,194 (cost-saving) to $4,484,122 with restricted eligibility. Conclusion: Along with the cost-effectiveness of WWE at widely accepted willingness-to-pay thresholds, these results can inform payers in deciding to fund WWE. In the absence of accepted thresholds to define affordability, these results can assist in comparing the affordability of WWE with other behavioral interventions. (© 2024 The Authors. Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International (OARSI).)
Databáze:	MEDLINE
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