PND4 Exploratory Cost-Effectiveness Analysis of Thread Embedding Acupuncture Plus Usual Care Versus Usual Care Alone for Treating Sequelae in Bell's Palsy Patients: An Economic Evaluation Alongside a Clinical Trial

Objectives: Bell’s palsy is one of the most common neurologic disorders of the cranial nerves, and approximately 29% of patients are experiencing long term sequelae. This study is a piggyback study of a clinical trial for evaluating the cost-effectiveness of thread embedding acupuncture (TEA) treatment plus usual care(UC) versus UC alone for treating the sequelae of Bell’s palsy patients in Korea. Methods: 56 patients were randomly allocated and received both treatments. Costs data including program cost, direct and indirect medical costs, productivity losses, and utility data of EQ-5D-5L were measured during the 8 week trial period at a university hospital in Korea. Incremental cost-effectiveness ratios (ICER) were estimated using cost and utility outcomes of both alternatives, and non-parametric bootstrap analyses were conducted for quantifying the uncertainty of ICER, Also, extrapolation of ICERs was also estimated assuming sustainable treatment effect beyond the trial period (8 weeks) with 5% annual discount rate. Results: From the health care payer (HCP) perspective, costs were estimated as 723330(S.D.67718) Won in UC group and 1665494(S.D.777225)Won in TEA group, and from the societal perspective costs were 1728170(S.D. 299309) in UC group and 2891513(S.D. 1082977) Won in TEA group, respectively. QALYs gained between two groups during the trial periods(8 weeks) were estimated as –0.00027 (S.D.0.00103) in the UC group and 0.00067(S.D. 0.00222) in TEA group (p-values =0.08). The ICERs and confidence intervals (CI) were estimated as 1,002,301,875 (431,597,115-10,859,903,648) Won per QALYs from the HCP perspective, and 1,237,598,112(521,040,729– 13,574,515,631) Won per QALYs from the societal perspective. Finally, we extrapolated health outcomes beyond the trial period and estimated ICER for 3 years as 35,149,888Won per QALY. Conclusions: This study results might show the cost-effectiveness possibility of TEA for treating sequelae in Bell’s palsy in Korea. Also, it might provide useful information for designing future confirmative clinical researches or modeling analyses.