{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:39:43Z","timestamp":1792697983208,"version":"4.5.0"},"reference-count":32,"publisher":"The Journal of Rheumatology","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>The 2012 American College of Rheumatology gout management guidelines recommend monitoring serum urate (SU) every 6 months after target SU has been achieved. Our objective was to determine through modeling whether this testing would be cost-effective, considering financial cost, quality of life, and estimated change in adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>A cost-utility analysis was completed with a 3-arm model: (1) no regular urate monitoring; (2) annual urate monitoring; and (3) biannual urate monitoring. Inputs to the model for health-related quality of life, flare rate, and treatment location were drawn from the medical literature and modeled over a lifetime horizon.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>No monitoring was the least costly (Australian$6974) but least effective [13.51 quality-adjusted life-yrs (QALY)], while annual urate monitoring [A$7117; 13.53 QALY; incremental cost-effectiveness ratio (ICER) A$13,678\/QALY gained] and biannual monitoring [A$7298; 13.54 QALY; ICER A$15,420 per QALY gained] were both cost-effective alternatives in base case analysis. Sensitivity analysis on both an individual component level and a probabilistic sensitivity analysis (PSA) demonstrated that the result was robust to changes in input variables. An improvement in adherence of \u2265 3.5% with biannual monitoring was all that was required to demonstrate cost-effectiveness. In PSA, the probability of biannual monitoring was 78%, no monitoring was 20%, and annual monitoring was 2%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>The results suggest that biannual SU monitoring after attaining target SU is the most cost-effective, compared with no testing and annual testing.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.170199","type":"journal-article","created":{"date-parts":[[2018,2,15]],"date-time":"2018-02-15T20:20:23Z","timestamp":1518726023000},"page":"697-704","source":"Crossref","is-referenced-by-count":13,"title":["The Cost-effectiveness of Biannual Serum Urate (SU) Monitoring after Reaching Target in Gout: A Health Economic Analysis Comparing SU Monitoring"],"prefix":"10.3899","volume":"45","author":[{"given":"Philip C.","family":"Robinson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Dalbeth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Donovan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2018,2,15]]},"reference":[{"key":"2018112909383040000_45.5.697.1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23176"},{"key":"2018112909383040000_45.5.697.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2015.02.004"},{"key":"2018112909383040000_45.5.697.3","first-page":"S145","article-title":"The economic impact of gout: a systematic literature review","volume":"30","author":"Trieste","year":"2012","journal-title":"Clin Exp Rheumatol"},{"key":"2018112909383040000_45.5.697.4","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21772"},{"key":"2018112909383040000_45.5.697.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2011.05.010"},{"key":"2018112909383040000_45.5.697.6","doi-asserted-by":"publisher","DOI":"10.1592\/phco.28.4.437"},{"key":"2018112909383040000_45.5.697.7","first-page":"1575","article-title":"Compliance with allopurinol therapy among managed care enrollees with gout: a retrospective analysis of administrative claims","volume":"31","author":"Riedel","year":"2004","journal-title":"J Rheumatol"},{"key":"2018112909383040000_45.5.697.8","doi-asserted-by":"publisher","DOI":"10.4065\/81.7.925"},{"key":"2018112909383040000_45.5.697.9","doi-asserted-by":"publisher","DOI":"10.1186\/ar2659"},{"key":"2018112909383040000_45.5.697.10","doi-asserted-by":"publisher","DOI":"10.1185\/03007990903017966"},{"key":"2018112909383040000_45.5.697.11","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.076182"},{"key":"2018112909383040000_45.5.697.12","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f1049"},{"key":"2018112909383040000_45.5.697.13","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0b013e3181945d2c"},{"key":"2018112909383040000_45.5.697.14","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes147"},{"key":"2018112909383040000_45.5.697.15","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker361"},{"key":"2018112909383040000_45.5.697.16","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes253"},{"key":"2018112909383040000_45.5.697.17","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2015.91"},{"key":"2018112909383040000_45.5.697.18","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.150310"},{"key":"2018112909383040000_45.5.697.19","unstructured":"Australian Government Department of Health . 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