Resource impact summary report

Resource impact summary report

Guidance recommendations

NICE has recommended that 8 digital technologies can be used in the NHS during the evidence generation period as options to manage mild to moderate symptoms of hip or knee osteoarthritis in adults.

These technologies can only be used if the evidence outlined in the evidence generation plan for digital technologies for managing mild to moderate symptoms of hip or knee osteoarthritis is being generated and as long as they have appropriate regulatory approval including NHS England's Digital Technology Assessment Criteria (DTAC) approval.

The technologies should be used in line with sections 1.2 and 1.3 of the guidance.

The technologies are designed to help people with mild to moderate symptoms of hip or knee osteoarthritis manage their condition remotely in the community, at a time that is convenient to their lifestyle. They are not intended to replace face-to-face care but may help reduce the number of appointments with a GP or first-contact practitioner, as well as onward referrals to musculoskeletal services that people may need.

Financial and capacity resource impact

Supplier costs vary because of differences in delivery models, access routes, target user groups, levels of professional input needed and additional features across the technologies. Resource impact will be influenced by local commissioning decisions, negotiated pricing agreements and the level of adoption of each technology. The unit costs in Table 1 are based on prices used in the companies' submissions and represent indicative figures before any local commissioning or pricing arrangements. Prices may be subject to change. Users should contact the relevant companies for full pricing details to suit their local use.

Table 1 Indicative cost of each technology per person (excluding VAT)
Technology Unit cost per person Cost basis

getUBetter

£18.86

Per year

Good Boost

£46.15

Per year

Hinge Health

£296.25

Per year

Joint Academy

£112.50

12 weeks

Phio Engage

£45.28

Per year

re.flex

£229.50

Per year

Sword Thrive

£250.00

Per year

TrackActive Me

Confidential

Confidential

The cost of TrackActive Me is confidential. Contact the company for pricing details.

Further resources may be needed to support access for groups such as older adults, people in deprived areas and people who do not have suitable devices or a stable internet connection.

The guidance says the technologies are not meant to replace face‑to‑face care, but they may help reduce the number of appointments with a GP or first-contact practitioner, and this could free up staff time. But there is still uncertainty about how cost effective the technologies are because the available evidence is limited. The committee agreed that better data for each technology would be needed to estimate cost effectiveness more accurately in future.

The data from the evidence generation plan for digital technologies for managing mild to moderate symptoms of hip or knee osteoarthritis will inform a further review by NICE in the future.

Benefits of using digital technologies

Digital technologies support and enhance the whole osteoarthritis management pathway. Below are some of the benefits:

  • Increase capacity (better access to services for more people): helpful for those living in rural areas or with limited mobility or busy schedules, and easier to join exercise and education programmes when NHS services are stretched.

  • Flexible and personalised support: exercises can be tailored to individual needs without extra appointments, or sometimes independently self-progressed.

  • Easy progress tracking: healthcare professionals can remotely check user data to see progress and offer support when needed.

  • Less pressure on healthcare services: people using digital tools to manage their condition may need fewer in-person healthcare visits.

Population covered for the digital technologies

Around 10 million people in the UK are estimated to have osteoarthritis, with 8.6 million having hip or knee osteoarthritis. Table 2 shows the estimated number of people in England with mild to moderate hip or knee osteoarthritis (Versus Arthritis. The state of musculoskeletal health 2024) for whom digital technology‑supported management may be suitable.

Table 2 People in England for whom digital technologies may be suitable
Details Percentage (%) Number in millions

People aged 16 years and over (ONS)

-

48.0

With osteoarthritis

17.34

8.3

With hip or knee osteoarthritis

88.63

7.4

With mild to moderate hip or knee osteoarthritis

83.00

6.1

For whom digital technologies may be suitable

25.00

1.5

Abbreviation: ONS, Office for National Statistics.

The estimate of how many people with mild to moderate hip or knee osteoarthritis for whom digital technologies may be suitable was based on clinical expert opinion. But, because the technologies vary in their delivery models, access routes, intended user groups, levels of professional input and additional features, the number of people for whom these technologies are suitable should be determined locally.

Treatment options for the eligible population

NICE's guideline on the diagnosis and management of osteoarthritis in over 16s recommends self-management for hip and knee osteoarthritis as part of standard care. This involves a personalised plan that includes education, therapeutic exercise, and, where appropriate, weight management. Manual therapy and devices (such as walking aids) may also be offered alongside therapeutic exercise, where appropriate.

There is unmet need across the NHS for self-management options. Some NHS services struggle to meet demand, and people must wait to access services. So, digital technologies may help address the unmet need by helping people to remotely access treatment options in the community, at times suitable for them.

Key information

Table 3 Key information

Speciality

Rheumatology

Disease area

Osteoarthritis

Pathway position

Management

Programme budgeting category

PBC15 Problems of the Musculoskeletal system

Commissioner(s)

Integrated care board

About this resource impact summary report

This resource impact summary report accompanies the NICE health technology guidance on digital technologies for managing mild to moderate symptoms of hip or knee osteoarthritis and should be read with it.

ISBN: 978-1-4731-8690-3

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