Modélisation mathématique pour évaluer l’impact économique de mesures de prévention dans la gonarthrose

Abstract : Objective: the purpose of this work was to design a decision support model to estimate the impact of a health action (weight loss in this case) in a population at risk for knee osteoarthritis (KOA) on the incidence and costs of KOA over a 5-year period. Methods: a Markov model with 2 states was developed and tested in a virtual population built from the incident cohort CHECK. Fictitious persons were randomly assigned to an initial health status per normal laws. At each cycle, these characteristics were used to determine the probability of developing KOA. To evaluate the effect of weight loss, overweight/obese patients lose 2.5 points of BMI during the 5-year period, based on the literature. The direct costs due to KOA and overweight were extracted from the literature. For the indirect costs, we evaluated the loss of productivity with the method of human capital. Results: the fictitious cohort contained 9300 patients, with 81.4% women and a mean BMI of 28.2+/- 2.7 kg/m². 6666 were overweight/obese and 788 of these, developed KOA. If this cohort benefited from management of overweight/obesity, 1586 patients would reach a BMI < 25 kg/m², and 148 KOA would be spared, ie, 23%. Savings over 5 years would be 240€ and 176€ per target patient in direct and indirect costs, respectively. Conclusion: this model allows to estimate the economic impact of weight loss in overweight/obese patients without KOA. A loss of 2.5 points of BMI would avoid 148 KOA and 416€ per target patient in 5 years.
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Master Thesis
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Sabine Trellu. Modélisation mathématique pour évaluer l’impact économique de mesures de prévention dans la gonarthrose. Médecine humaine et pathologie. 2017. ⟨dumas-01985919⟩

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