dc.contributor.author | Grotle, Margreth | |
dc.contributor.author | Bråten, Lars Christian Haugli | |
dc.contributor.author | Brox, Jens Ivar | |
dc.contributor.author | Espeland, Ansgar | |
dc.contributor.author | Zolic-Karlsson, Zinajda | |
dc.contributor.author | Killingmo, Rikke Munk | |
dc.contributor.author | Tingulstad, Alexander | |
dc.contributor.author | Grøvle, Lars | |
dc.contributor.author | Johanessen, Anne Froholdt | |
dc.contributor.author | Kristoffersen, Per Martin | |
dc.contributor.author | Wigemyr, Monica | |
dc.contributor.author | van Tulder, Maurits W. | |
dc.contributor.author | Storheim, Kjersti | |
dc.contributor.author | Zwart, John-Anker | |
dc.date.accessioned | 2021-03-12T10:02:09Z | |
dc.date.available | 2021-03-12T10:02:09Z | |
dc.date.created | 2020-06-23T09:56:36Z | |
dc.date.issued | 2020 | |
dc.identifier.issn | 2044-6055 | |
dc.identifier.uri | https://hdl.handle.net/11250/2733090 | |
dc.description.abstract | Objective
To evaluate the cost–utility of 100 days of antibiotics in patients with chronic low back pain (LBP) and type I or II Modic changes included in the Antibiotic treatment In patients with chronic low back pain and Modic changes (AIM) study.
Design
A cost–utility analysis from a societal and healthcare perspective alongside a double-blinded, parallel group, placebo, multicentre trial.
Setting
Hospital outpatient clinics at six hospitals in Norway. The main results from the AIM study showed a small effect in back-related disability in favour of the antibiotics group, and slightly larger in those with type I Modic changes, but this effect was below the pre-defined threshold for clinically relevant effect.
Participants
180 patients with chronic LBP, previous disc herniation and Modic changes type I (n=118) or type II (n=62) were randomised to antibiotic treatment (n=89) or placebo-control (n=91).
Interventions
Oral treatment with either 750 mg amoxicillin or placebo three times daily for 100 days.
Main outcome measures
Quality-adjusted life years (QALYs) by EuroQoL-5D over 12 months and costs for healthcare and productivity loss measured in Euro (€1=NOK 10), in the intention-to-treat population. Cost–utility was expressed in incremental cost-effectiveness ratio (ICER).
Results
Mean (SD) total cost was €21 046 (20 105) in the amoxicillin group and €19 076 (19 356) in the placebo group, mean difference €1970 (95% CI; −3835 to 7774). Cost per QALY gained was €24 625. In those with type I Modic changes, the amoxicillin group had higher healthcare consumption than the placebo group, resulting in €39 425 per QALY gained. Given these ICERs and a willingness-to-pay threshold of €27 500 (NOK 275 000), the probability of amoxicillin being cost-effective was 51%. Even when the willingness-to-pay threshold increased to €55 000, the probability of amoxicillin being cost-effective was never higher than 53%.
Conclusions
Amoxicillin treatment showed no evidence of being cost-effective for people with chronic LBP and Modic changes during 1-year follow-up. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | BMJ Publishing Group | en_US |
dc.rights | Navngivelse-Ikkekommersiell 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/deed.no | * |
dc.title | Cost–utility analysis of antibiotic treatment in patients with chronic low back pain and Modic changes: results from a randomised, placebo-controlled trial in Norway (the AIM study) | en_US |
dc.type | Journal article | en_US |
dc.type | Peer reviewed | en_US |
dc.description.version | publishedVersion | en_US |
dc.rights.holder | Copyright Author(s) (or their
employer(s)) 2020. | en_US |
dc.source.articlenumber | e035461 | en_US |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |
dc.identifier.doi | 10.1136/bmjopen-2019-035461 | |
dc.identifier.cristin | 1816711 | |
dc.source.journal | BMJ Open | en_US |
dc.identifier.citation | BMJ Open. 2020, 10 (6), e035461. | en_US |
dc.source.volume | 10 | en_US |
dc.source.issue | 6 | en_US |