A multidisciplinary lifestyle programme for patients with rheumatoid arthritis and metabolic syndrome-associated osteoarthritis: economic evaluation alongside the 'Plants for Joints' randomized controlled trials

Scand J Rheumatol. 2026 Jan;55(1):21-31. doi: 10.1080/03009742.2025.2550133. Epub 2025 Nov 10.

Abstract

Objective: To evaluate the cost-effectiveness of the 'Plants for Joints' intervention for rheumatoid arthritis (RA) and metabolic syndrome-associated osteoarthritis (MSOA) patients over 16 weeks.

Method: Data from two randomized controlled trials were analysed. The first included 77 RA patients (intervention = 40; control = 37) and the second 64 MSOA patients (intervention = 32; control = 32). The intervention comprised a 16 week lifestyle programme including a whole-food plant-based diet, exercise, and stress management; control participants received usual care. Data from both trials were analysed together and separately. Costs were measured from societal and healthcare perspectives. Effects were expressed in quality-adjusted life-years (QALYs).

Results: The intervention cost €886/patient. Intervention group participants gained more QALYs than the control group (0.009; 95% confidence interval -0.004 to 0.023), equivalent to 3.3 additional days in 'perfect health' (0.009 × 365). Healthcare costs were higher in the intervention group, while societal costs were lower. None of these differences was statistically significant. From a societal perspective, the intervention had a moderate to high probability of being cost-effective compared with usual care, while the probability was low from a healthcare perspective. Stratified analyses indicated that the probability of cost-effectiveness was higher in RA than in MSOA patients. This difference became less pronounced after excluding outliers.

Conclusion: The Plants for Joints intervention demonstrated a relatively high probability of cost-effectiveness from a societal perspective, although this was lower from a healthcare perspective. If these benefits are sustained in the long term, this intervention may reduce the disease and economic burden of arthritic conditions.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Arthritis, Rheumatoid* / complications
  • Arthritis, Rheumatoid* / economics
  • Arthritis, Rheumatoid* / therapy
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Life Style*
  • Male
  • Metabolic Syndrome* / complications
  • Metabolic Syndrome* / economics
  • Metabolic Syndrome* / therapy
  • Middle Aged
  • Osteoarthritis* / economics
  • Osteoarthritis* / etiology
  • Osteoarthritis* / therapy
  • Quality-Adjusted Life Years