Cost-utility analysis
absence or disability, SD, disability
The total between-group difference in QALYs was 0.06 (95% CI −0.02, 0.15) after 24 months, in favour of the intervention group. The distribution of EQ-5D-5L utility score across the different time points for the two groups are shown in 
Mean direct and indirect healthcare costs (mean and SD) per patient for the intervention and control group (n=180)The table also shows unit price and the resource use (n).All costs are given in Euro (€1=Kr 10) and adjusted to 2019.*DRG (diagnosis-related group system).†List of reimbursement codes.‡Rates for physiotherapists.§Official statistics of average wage.¶Based on real costs.The mean cost of multimodal occupational therapy intervention (baseline information on hand OA, instruction in hand exercises, assistive devices, and customisation of orthoses, and adjustment of hand exercises and orthoses after 14 days) was approximately €500 per patient. Surgery accounted for the largest between-group difference related to direct healthcare costs with 22 surgical procedures in the intervention group and 33 surgical procedures in the control group, resulting in a €550 difference in surgical cost per patient between the two groups. The use of physiotherapy/occupational therapy also constituted a high cost. However, almost one-third of these costs were related to the predetermined assessment points (4, 18 and 24 months) that were part of the study but not the actual OT intervention (€375 per patient in the control group and €307 per patient in the intervention group).Productivity loss due to sickness absence or disability benefits was the largest contributor to the total costs in both groups. However, at baseline, only 7% of the sickness absence in both groups was reported to be due to hand OA, and the percentages at 4, 18 and 24 months were 6%, 2% and 0.5%, respectively. Similar numbers of patients in the two groups were retired at baseline (34% in the control group vs 32% in the intervention group), 4 months (36% vs 34%) and 24 months (42% vs 43%). However, more patients in the intervention group (43%) retired between 4 and 18 months than in the control group (36%), indicating that fewer patients contributed to productivity loss in the intervention group during this period.
Cost-utility analysis of mean costs (SD), mean effects (SD), incremental differences in costs and effects (95% CI) and incremental cost-effectiveness ratio (ICER) for direct and total direct and indirect costs (n=180)Direct costs, €: self-reported use of primary and specialist healthcare, including surgery.Indirect costs, €: productivity loss from sickness absence due to surgery, costs related to informal help at home, productivity loss from sickness absence and disability benefits excluding sickness absence due to surgery.Total cost, €: direct costs+indirect costs.*Mean effect without imputations; intervention group 1.58 (0.28), control group 1.51 (0.28).