SAT0513 Functional impairment rather than burden of co-morbidities is associated with a 5-year change in health state utility in hip and knee osteoarthritis: results from the khoala cohort study

International audienc

Economic evaluation of a school-based strategy to prevent overweight and obesity in French adolescents: insights from the PRALIMAP randomised trial

International audienceObjectives: This study aimed to provide cost-effectiveness and budget impact analyses of a school-basedoverweight/obesity screening and care prevention strategy among adolescents.Study design: Cost-effectiveness and budget impact analyses.Methods: Data from 3538 adolescents who participated in a school-based randomised controlled trial inthe Northeast of France were used. Costs (from a public payer's perspective) included screening foroverweight and obesity and subsequent care. Effectiveness was measured as the change in body massindex (kilogram per square metre), prevalence of overweight/obesity, moderate physical activity energyexpenditure, duration and frequency and total sitting time. The incremental cost-effectiveness ratio wascalculated, and a budget impact analysis was conducted.Results: The screening and care strategy resulted in an incremental cost-effectiveness ratio of V1634.48per averted case of overweight/obesity and V255.43 per body mass index unit decrease. The costs forincreasing moderate physical activity by 1000 metabolic equivalent of task-min/week, duration by60 min/week and frequency 1 day/week were V165.28, V39.21 and V93.66 per adolescent, respectively.Decreasing total sitting time by 60 min/week had a cost of V8.49 per adolescent. The cost of imple-menting the strategy nationally was estimated to be V50.1 million with a payback period from 3.6 to 7.3years.Conclusions: The screening and care strategy could be an efficient way to prevent overweight and obesityamong adolescents. Future studies should investigate how the current results could be achieved inschools with different settings and thus justify its relevance for overweight and obesity prevention topolicy-makers

Health resource use and costs of symptomatic knee and/or hip osteoarthritis

International audienceBackground: Data on the economic consequences of hip and knee osteoarthritis (OA) are scarce. We aimed to estimate the annual direct and indirect costs for patients followed for hip and/or knee OA in the Knee and Hip Osteoarthritis Long term Assessment (KHOALA) cohort.Methods: The KHOALA cohort, set up from 2007 to 2009, is a French multicenter study of 878 individuals with symptomatic knee/hip OA who were 40e75 years old. Resources used were collected annually for 5 years. Costs were assigned by using official sources and expressed in 2018 euros per patient.Results: The mean annual total costs per patient over the 5-year study period were 2,180 ± 5,305V. The mean annual direct medical costs per patient were 2,120 ± 5,275V and mean annual indirect costs per patient 180 ± 1,735V for people of working age. Costs increased slightly over the study period. Drugs were the largest cost share, representing over 50% of all direct costs. However, the proportion attributable to OA drugs accounted for only 10.5% of drug costs. The second cost share was hospitalizations; hip and knee prosthetic surgery accounted for 27% of surgery hospitalization costs. Health professional visits were the third cost share, accounting for 3% of direct medical costs. The median costs induced could be as high as 2 billion V/year (IQR 0.7e4.3) in France.Conclusion: Hip and knee OA costs were substantial and increased over the study period in France. However, the costs attributable to OA represented only a small fraction of overall costs