scholarly journals A PRELIMINARY COST-UTILITY ANALYSIS OF THE PROSTHETIC CARE INNOVATIONS: CASE OF THE KEEP WALKING IMPLANT

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Lluis Guirao ◽  
Beatriz Samitier ◽  
Laurent Frossard
Keyword(s):  
Weight Bearing ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Healthcare Organizations ◽  
Medical Treatments ◽  
Basic Framework ◽  
Hands On ◽  
Care Innovation

Several obstacles must be overcome before preliminary cost-utility analyses (CUA) of prosthetic care innovations can be routinely performed. The basic framework of preliminary CUAs and hands-on recommendations suggested previously might contribute to wider adoption. However, a practical application for an emerging intervention is needed to showcase the capacity of this proposed preliminary CUA framework. This study presented the outcomes of preliminary CUA of the distal weight bearing Keep Walking Implant (KWI), an emerging prosthetic care innovation that may reduce socket fittings for individuals with transfemoral amputation. The preliminary CUAs compared the provision of prosthetic care without (usual intervention) and with the KWI (new intervention) using a 15-step iterative process focused on feasibility, constructs, analysis, and interpretations of outcomes from an Australia government prosthetic care perspective over a six-year time horizon. Baseline and incremental costs were extracted from schedules of allowable expenses. Baseline utilities were extracted from a study and converted into quality-adjusted life-year (QALY). Incremental utilities were calculated based on sensible gains of QALY from baselines. The provision of the prosthetic care with the KWI could generate an indicative incremental cost-utility ratio (ICUR) of -$36,890 per QALY, which was $76,890 per QALY below willingness-to-pay threshold, provided that the KWI reduces costs by $17,910 while increasing utility by 0.485 QALY compared to usual interventions. This preliminary CUA provided administrators of healthcare organizations in Australia and elsewhere with prerequisite evidence justifying further access to market and clinical introduction of the KWI. Altogether, this work suggests that the basic framework of the preliminary CUA of a prosthetic care innovation proposed previously is feasible and informative when a series of assumptions are carefully considered. This study further confirms that preliminary CUAs prosthetic care interventions might be a relevant alternative to full CUA for other medical treatments. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/36366/28329 How To Cite: Guirao L, Samitier B, Frossard L. A preliminary cost-utility analysis of the prosthetic care innovations: case of the keep walking implant. Canadian Prosthetics & Orthotics Journal. 2021; Volume 4, Issue 2, No.11.  https://doi.org/10.33137/cpoj.v4i2.36366 Corresponding Author: Laurent Frossard (PhD), Professor of BionicsYourResearchProject Pty Ltd, Brisbane, Australia.E-Mail: [email protected] number: https://orcid.org/0000-0002-0248-9589 

scholarly journals A PRELIMINARY COST-UTILITY ANALYSIS OF THE PROSTHETIC CARE INNOVATIONS: BASIC FRAMEWORK

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Laurent Frossard
Keyword(s):  
Early Stage ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Sufficient Evidence ◽  
Utility Analysis ◽  
New Approach ◽  
Basic Framework ◽  
Hands On ◽  
High Uncertainty ◽  
Selection Of

A preliminary cost-utility analysis (CUA) of prosthetic care innovations can provide timely information during the early stage of product development and clinical usage. Concepts of preliminary CUAs are emerging. However, several obstacles must be overcome before these analyses are performed routinely. Disparities of methods and high uncertainty make the outcomes of usual preliminary CUAs challenging to interpret, appraise and share. These shortcomings create opportunities for a basic framework of preliminary CUAs. First, I introduced a basic framework of a preliminary CUA built around a series of constructs and hands-on recommendations. Then, I appraised this framework considering the strengths and weaknesses, barriers and facilitators, and return on investment. The design of the basic framework was determined through the review of health economic and prosthetic-specific literature. A preliminary CUA comparing the costs and utilities between usual intervention and an innovation could be achieved through a 15-step iterative process focusing on feasibility, constructs, analysis, and interpretation of outcomes. This CUA provides sufficient evidence to identify knowledge gaps and improvement areas, educate about the design of subsequent full CUAs, and obtain fast-track approval from governing bodies. Like previous CUAs, the main limitations were inherent to the constructs (e.g., narrow perspective, plausible scenarios, mid-term time horizon, substantial assumptions, data mismatch, high uncertainty). Key facilitators potentially transferable across preliminary CUAs of prosthetic care innovations included choosing abided constructs, capitalizing on prior schedules of expenses, and benchmarking baseline or incremental utilities. This new approach with preliminary CUA can simplify the selection of methods, standardize outcomes, ease comparisons between innovations, and streamline pathways for adoption. Further collegial efforts toward validating standard preliminary CUAs will facilitate access to economic prosthetic care innovations, improving the lives of individuals suffering from limb loss worldwide. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/36365/28328 How To Cite: Frossard L. A preliminary cost-utility analysis of the prosthetic care innovations: basic framework. Canadian Prosthetics & Orthotics Journal. 2021; Volume 4, Issue 2, No.10. https://doi.org/10.33137/cpoj.v4i2.36365 Corresponding Author: Laurent Frossard (PhD), Professor of BionicsYourResearchProject Pty Ltd, Brisbane, Australia.E-Mail: [email protected] number: https://orcid.org/0000-0002-0248-9589

scholarly journals A one-year cost–utility analysis of REBOA versus RTACC for non-compressible torso haemorrhage

Trauma ◽  
2017 ◽  
Vol 21 (1) ◽  
pp. 45-54 ◽  
Author(s):  
Maxwell S Renna ◽  
Cristiano van Zeller ◽  
Farah Abu-Hijleh ◽  
Cherlyn Tong ◽  
Jasmine Gambini ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Incremental Cost Effectiveness Ratio ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Cost Effectiveness Ratio ◽  
One Year ◽  
Quality Adjusted Life

Introduction Major trauma is a leading cause of death and disability in young adults, especially from massive non-compressible torso haemorrhage. The standard technique to control distal haemorrhage and maximise central perfusion is resuscitative thoracotomy with aortic cross-clamping (RTACC). More recently, the minimally invasive technique of resuscitative endovascular balloon occlusion of the aorta (REBOA) has been developed to similarly limit distal haemorrhage without the morbidity of thoracotomy; cost–utility studies on this intervention, however, are still lacking. The aim of this study was to perform a one-year cost–utility analysis of REBOA as an intervention for patients with major traumatic non-compressible abdominal haemorrhage, compared to RTACC within the U.K.’s National Health Service. Methods A retrospective analysis of the outcomes following REBOA and RTACC was conducted based on the published literature of survival and complication rates after intervention. Utility was obtained from studies that used the EQ-5D index and from self-conducted surveys. Costs were calculated using 2016/2017 National Health Service tariff data and supplemented from further literature. A cost–utility analysis was then conducted. Results A total of 12 studies for REBOA and 20 studies for RTACC were included. The mean injury severity scores for RTACC and REBOA were 34 and 39, and mean probability of death was 9.7 and 54%, respectively. The incremental cost-effectiveness ratio of REBOA when compared to RTACC was £44,617.44 per quality-adjusted life year. The incremental cost-effectiveness ratio, by exceeding the National Institute for Health and Clinical Effectiveness’s willingness-to-pay threshold of £30,000/quality-adjusted life year, suggests that this intervention is not cost-effective in comparison to RTACC. However, REBOA yielded a 157% improvement in utility with a comparatively small cost increase of 31.5%. Conclusion Although REBOA has not been found to be cost-effective when compared to RTACC, ultimately, clinical experience and expertise should be the main factor in driving the decision over which intervention to prioritise in the emergency context.

A Cost-Utility Analysis of Abdominal Hysterectomy Versus Transcervical Endometrial Resection for the Surgical Treatment of Menorrhagia

1998 ◽  
Vol 14 (2) ◽  
pp. 302-319 ◽  
Author(s):  
Mark Sculpher
Keyword(s):  
Cost Effective ◽  
Abdominal Hysterectomy ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Health State ◽  
Utility Analysis ◽  
Major Health ◽  
Parameter Values ◽  
Quality Adjusted Life

AbstractMenorrhagia, or heavy regular menstrual bleeding, represents a major health burden to women. Trials comparing abdominal hysterectomy (AH) with transcervical resection of the endometrium (TCRE) for the condition have shown that, although the duration and severity of convalescence is less with TCRE, AH produces a permanent solution to heavy bleeding while TCRE fails in a proportion of women by 2 years. However, by 2 years, TCRE costs only 71% that of AH. This paper presents a cost-utility analysis to assess which procedure is more cost-effective overall. Under most plausible parameter values and on the basis of health state values elicited from a sample of women with menorrhagia, AH is likely to be considered more cost-effective than TCRE if purchasers are willing to pay an additional cost of at least £6,500 per extra quality-adjusted life-year generated by AH.

Cost-Utility Analysis of Group Living in Dementia Care

1995 ◽  
Vol 11 (1) ◽  
pp. 49-65 ◽  
Author(s):  
Anders Wimo ◽  
Bengt Mattson ◽  
Ingvar Krakau ◽  
Tua Eriksson ◽  
Anders Nelvig ◽  
...  
Keyword(s):  
Group Living ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Dementia Patients ◽  
Methodological Problems ◽  
Institutionalized Patients ◽  
The Cost ◽  
Quality Adjusted Life

AbstractA cost-utility analysis (CUA) was applied to group living for dementia patients. A Markov-model of an expected life-length of 8 years was used. Forty-six patients in group living were compared to 39 patients living at home by inclusion and 23 institutionalized patients. When the cost per gained quality-adjusted life-year (QALY) was calculated, the group living alternative was the most favorable for the patients, giving a cost per paired QALY of US dollars > 0. In the extensive sensitivity analysis the main result was consistent but methodological problems were indicated.

Cost–utility analysis of an integrated genetic/epigenetic test for assessing risk for coronary heart disease

Epigenomics ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 531-547 ◽  
Author(s):  
Younsoo Jung ◽  
David Frisvold ◽  
Timur Dogan ◽  
Meeshanthini Dogan ◽  
Rob Philibert
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cost Effectiveness ◽  
Healthcare Spending ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Potential Impact ◽  
Quality Adjusted Life

Aim: New epigenetically based methods for assessing risk for coronary heart disease may be more sensitive but are generally more costly than current methods. To understand their potential impact on healthcare spending, we conducted a cost–utility analysis. Methods: We compared costs using the new Epi + Gen CHD™ test with those of existing tests using a cohort Markov simulation model. Results: We found that use of the new test was associated with both better survival and highly competitive negative incremental cost–effectiveness ratios ranging from -$42,000 to -$8000 per quality-adjusted life year for models with and without a secondary test. Conclusion: The new integrated genetic/epigenetic test will save money and lives under most real-world scenarios. Similar advantages may be seen for other epigenetic tests.

Cost-utility analysis of eating disorder treatment

2011 ◽  
Author(s):  
V. Pohjolainen ◽  
P. Rasanen ◽  
R. P. Roine ◽  
H. Sintonen ◽  
K. Wahlbeck ◽  
...  
Keyword(s):  
Eating Disorder ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Eating Disorder Treatment ◽  
Disorder Treatment
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