Cost-effectiveness of the HiBalance training program for elderly with Parkinson’s disease: analysis of data from a randomized controlled trial
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Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
SAGE Publications
Abstract
OBJECTIVE: To determine the cost-effectiveness of the HiBalance training program for managing Parkinson’s disease (PD)-related balance and gait disorders.
DESIGN: Cost comparison design following the randomized controlled trial comparing a novel balance training intervention with care as usual.
SUBJECTS: A total of 100 participants with mild–moderate PD were randomized to either the intervention (n = 51) or the control group (n = 49).
INTERVENTION: A 10-week (three times per week), group-based, progressive balance training program, led by two physical therapists.
MAIN OUTCOMES: All program costs were collected for both groups. Cost-utility was evaluated using quality-adjusted life years (QALYs) and cost-effectiveness measures were the Mini Balance Evaluation Systems Test (Mini-BESTest; assessing balance performance) and gait velocity. Incremental cost-effectiveness ratios were calculated and a probabilistic sensitivity analysis was conducted.
RESULTS: The between-group difference in QALYs was 0.043 (95% confidence interval (CI): 0.011–0.075), favoring the intervention group. Between-group differences in balance performance and gait velocity were 2.16 points (95% CI: 1.19–3.13) and 8.2 cm/second (95% CI: 2.9–13.6), respectively, favoring the intervention group. The mean cost per participant in the intervention group was 16,222 SEK (€1649) compared to 2696 SEK (€274) for controls. The estimated incremental cost-effectiveness ratios were 314,558 SEK (€31,969) for an additional QALY, 6262 SEK (€631) for one point improvement in balance performance, and 1650 SEK (€166) for 1 cm/second increase in gait velocity. Sensitivity analyses indicated a high probability (85%) of program success.
CONCLUSION: In terms of QALYs, the HiBalance program demonstrated a high probability of cost-effectiveness in the short-term perspective when considering the willingness-to-pay thresholds used in Europe.
Description
Keywords
Parkinson’s disease, HiBalance training, Cost-effectiveness, Economic evaluation, Quality-adjusted life years
Citation
Joseph, C. et al. (2018). Cost-effectiveness of the HiBalance training program for elderly with Parkinson’s disease: analysis of data from a randomized controlled trial. Clinical Rehabilitation, 2018: 1-11.