Aims and objectivesTo examine the cost-effectiveness of semi-rigid ankle brace to facilitate return to work following first-time acute ankle sprains. DesignEconomic evaluation based on cost-utility analysis. BackgroundAnkle sprains are a source of morbidity and absenteeism from work, accounting for 15-20% of all sports injuries. Semi-rigid ankle brace and taping are functional treatment interventions used by Musculoskeletal Physiotherapists and Nurses to facilitate return to work following acute ankle sprains. MethodsA decision model analysis, based on cost-utility analysis from the perspective of National Health Service was used. The primary outcomes measure was incremental cost-effectiveness ratio, based on quality-adjusted life years. Costs and quality of life data were derived from published literature, while model clinical probabilities were sourced from Musculoskeletal Physiotherapists. ResultsThe cost and quality adjusted life years gained using semi-rigid ankle brace was 184 and 0.72 respectively. However, the cost and quality adjusted life years gained following taping was 155 and 0.61 respectively. The incremental cost-effectiveness ratio for the semi-rigid brace was 263 pound per quality adjusted life year. Probabilistic sensitivity analysis showed that ankle brace provided the highest net-benefit, hence the preferred option. ConclusionTaping is a cheaper intervention compared with ankle brace to facilitate return to work following first-time ankle sprains. However, the incremental cost-effectiveness ratio observed for ankle brace was less than the National Institute for Health and Care Excellence threshold and the intervention had a higher net-benefit, suggesting that it is a cost-effective intervention. Decision-makers may be willing to pay 263 pound for an additional gain in quality adjusted life year. Relevance to clinical practiceThe findings of this economic evaluation provide justification for the use of semi-rigid ankle brace by Musculoskeletal Physiotherapists and Nurses to facilitate return to work in individuals with first-time ankle sprains.