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Cost-effectiveness of surgical treatments compared with early structured physiotherapy in secondary care for adults with primary frozen shoulder: an economic evaluation of the UK FROST trial

AIMS: A pragmatic multicentre randomized controlled trial, UK FROzen Shoulder Trial (UK FROST), was conducted in the UK NHS comparing the cost-effectiveness of commonly used treatments for adults with primary frozen shoulder in secondary care. METHODS: A cost utility analysis from the NHS perspectiv...

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Autores principales: Corbacho, Belen, Brealey, Stephen, Keding, Ada, Richardson, Gerry, Torgerson, David, Hewitt, Catherine, McDaid, Catriona, Rangan, Amar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Editorial Society of Bone & Joint Surgery 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8384443/
https://www.ncbi.nlm.nih.gov/pubmed/34420365
http://dx.doi.org/10.1302/2633-1462.28.BJO-2021-0075.R1
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author Corbacho, Belen
Brealey, Stephen
Keding, Ada
Richardson, Gerry
Torgerson, David
Hewitt, Catherine
McDaid, Catriona
Rangan, Amar
author_facet Corbacho, Belen
Brealey, Stephen
Keding, Ada
Richardson, Gerry
Torgerson, David
Hewitt, Catherine
McDaid, Catriona
Rangan, Amar
author_sort Corbacho, Belen
collection PubMed
description AIMS: A pragmatic multicentre randomized controlled trial, UK FROzen Shoulder Trial (UK FROST), was conducted in the UK NHS comparing the cost-effectiveness of commonly used treatments for adults with primary frozen shoulder in secondary care. METHODS: A cost utility analysis from the NHS perspective was performed. Differences between manipulation under anaesthesia (MUA), arthroscopic capsular release (ACR), and early structured physiotherapy plus steroid injection (ESP) in costs (2018 GBP price base) and quality adjusted life years (QALYs) at one year were used to estimate the cost-effectiveness of the treatments using regression methods. RESULTS: ACR was £1,734 more costly than ESP ((95% confidence intervals (CIs) £1,529 to £1,938)) and £1,457 more costly than MUA (95% CI £1,283 to £1,632). MUA was £276 (95% CI £66 to £487) more expensive than ESP. Overall, ACR had worse QALYs compared with MUA (-0.0293; 95% CI -0.0616 to 0.0030) and MUA had better QALYs compared with ESP (0.0396; 95% CI -0.0008 to 0.0800). At a £20,000 per QALY willingness-to-pay threshold, MUA had the highest probability of being cost-effective (0.8632) then ESP (0.1366) and ACR (0.0002). The results were robust to sensitivity analyses. CONCLUSION: While ESP was less costly, MUA was the most cost-effective option. ACR was not cost-effective. Cite this article: Bone Jt Open 2021;2(8):685–695.
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spelling pubmed-83844432021-09-03 Cost-effectiveness of surgical treatments compared with early structured physiotherapy in secondary care for adults with primary frozen shoulder: an economic evaluation of the UK FROST trial Corbacho, Belen Brealey, Stephen Keding, Ada Richardson, Gerry Torgerson, David Hewitt, Catherine McDaid, Catriona Rangan, Amar Bone Jt Open Shoulder & Elbow AIMS: A pragmatic multicentre randomized controlled trial, UK FROzen Shoulder Trial (UK FROST), was conducted in the UK NHS comparing the cost-effectiveness of commonly used treatments for adults with primary frozen shoulder in secondary care. METHODS: A cost utility analysis from the NHS perspective was performed. Differences between manipulation under anaesthesia (MUA), arthroscopic capsular release (ACR), and early structured physiotherapy plus steroid injection (ESP) in costs (2018 GBP price base) and quality adjusted life years (QALYs) at one year were used to estimate the cost-effectiveness of the treatments using regression methods. RESULTS: ACR was £1,734 more costly than ESP ((95% confidence intervals (CIs) £1,529 to £1,938)) and £1,457 more costly than MUA (95% CI £1,283 to £1,632). MUA was £276 (95% CI £66 to £487) more expensive than ESP. Overall, ACR had worse QALYs compared with MUA (-0.0293; 95% CI -0.0616 to 0.0030) and MUA had better QALYs compared with ESP (0.0396; 95% CI -0.0008 to 0.0800). At a £20,000 per QALY willingness-to-pay threshold, MUA had the highest probability of being cost-effective (0.8632) then ESP (0.1366) and ACR (0.0002). The results were robust to sensitivity analyses. CONCLUSION: While ESP was less costly, MUA was the most cost-effective option. ACR was not cost-effective. Cite this article: Bone Jt Open 2021;2(8):685–695. The British Editorial Society of Bone & Joint Surgery 2021-08-23 /pmc/articles/PMC8384443/ /pubmed/34420365 http://dx.doi.org/10.1302/2633-1462.28.BJO-2021-0075.R1 Text en © 2021 Author(s) et al. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Shoulder & Elbow
Corbacho, Belen
Brealey, Stephen
Keding, Ada
Richardson, Gerry
Torgerson, David
Hewitt, Catherine
McDaid, Catriona
Rangan, Amar
Cost-effectiveness of surgical treatments compared with early structured physiotherapy in secondary care for adults with primary frozen shoulder: an economic evaluation of the UK FROST trial
title Cost-effectiveness of surgical treatments compared with early structured physiotherapy in secondary care for adults with primary frozen shoulder: an economic evaluation of the UK FROST trial
title_full Cost-effectiveness of surgical treatments compared with early structured physiotherapy in secondary care for adults with primary frozen shoulder: an economic evaluation of the UK FROST trial
title_fullStr Cost-effectiveness of surgical treatments compared with early structured physiotherapy in secondary care for adults with primary frozen shoulder: an economic evaluation of the UK FROST trial
title_full_unstemmed Cost-effectiveness of surgical treatments compared with early structured physiotherapy in secondary care for adults with primary frozen shoulder: an economic evaluation of the UK FROST trial
title_short Cost-effectiveness of surgical treatments compared with early structured physiotherapy in secondary care for adults with primary frozen shoulder: an economic evaluation of the UK FROST trial
title_sort cost-effectiveness of surgical treatments compared with early structured physiotherapy in secondary care for adults with primary frozen shoulder: an economic evaluation of the uk frost trial
topic Shoulder & Elbow
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8384443/
https://www.ncbi.nlm.nih.gov/pubmed/34420365
http://dx.doi.org/10.1302/2633-1462.28.BJO-2021-0075.R1
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