scholarly journals Cost-Utility Analysis of Venous Thromboembolism Prophylaxis Strategies for People Undergoing Elective Total Hip and Total Knee Replacement Surgeries in the English National Health Service

2018 ◽  
Vol 9 ◽  
Author(s):  
Dalia M. Dawoud ◽  
David Wonderling ◽  
Jessica Glen ◽  
Sedina Lewis ◽  
Xavier L. Griffin ◽  
...  
Author(s):  
Kinga Ciemniewska-Gorzela ◽  
Tomasz Piontek ◽  
Jakub Naczk ◽  
Paweł Bąkowski ◽  
Justus Gille ◽  
...  

Introduction Clinical data has indicated that Arthroscopic Matrix-based Meniscus Repair (AMMR) offers a means to preserve the meniscus in patients who would otherwise be scheduled for meniscectomy, although AMMR has significant upfront costs. Aim The objective of this study was to estimate the cost-effectiveness of AMMR in Poland in both the National Health Service (PNHS) and from the perspective of private patients (PP). Material and methods A Markov health-state model was developed to evaluate the cost-utility analysis of AMMR compared to meniscectomy (ME) for patients with a complex meniscus tear, using a 10-years horizon, modelling a cohort of 1000 patients. Initial probabilities and clinical course were simulated based on previously published data. A literature review identified different clinical outcome probabilities and health-related utility scores associated with each health state. Cost-effectiveness was presented as an indicator of Incremental Cost-Utility Ratio (ICUR). Costs were taken from published sources for the perspective of PNHS and from a private clinic offers for the perspective of PP. Results In the 10-year horizon, AMMR was associated with an increase in discounted qualityadjusted life-years (QALYs) to 7 778.25 compared to 7 454.33 for ME. In both perspectives, (PNHS and PP) the ICUR cost is smaller than willingness to pay (WTP) parameter (PNHSICUR = 34.212.92 versus PP-ICUR = 29.897.36). Conclusions: Despite the increase in costs, the procedure is cost-effective at standard thresholds used in Poland for analyzed perspectives. Keywords: knee; meniscus; collagen matrix; cost-effectiveness; economic analysis; Markov model


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