Total Shoulder Arthroplasty Is Cost-Effective Compared with Hemiarthroplasty
| Autor: | Sasha van Katwyk, Srishti Kumar, Kednapa Thavorn, Peter Lapner |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Reoperation Health utility Cost-Benefit Analysis medicine.medical_treatment Osteoarthritis Hip Arthritis Rheumatoid 03 medical and health sciences 0302 clinical medicine Age groups Humans Medicine Orthopedics and Sports Medicine In patient health care economics and organizations Aged Retrospective Studies 030222 orthopedics Shoulder Joint business.industry 030229 sport sciences General Medicine Evidence-based medicine Middle Aged Arthroplasty Treatment Outcome Arthroplasty Replacement Shoulder Economic evaluation Female Surgery Hemiarthroplasty Quality-Adjusted Life Years Level ii business Demography Decision analysis |
| Zdroj: | Journal of Bone and Joint Surgery. 103:1499-1509 |
| ISSN: | 1535-1386 0021-9355 |
| DOI: | 10.2106/jbjs.20.00678 |
| Popis: | Background Although outcome studies generally demonstrate the superiority of a total shoulder arthroplasty (TSA) over a hemiarthroplasty (HA), comparative cost-effectiveness has not been well studied. From a publicly funded health-care system's perspective, this study compared the costs and quality-adjusted life-years (QALYs) in patients who underwent TSA with those in patients who underwent HA. Methods We conducted a cost-utility analysis using a Markov model to simulate the costs and QALYs for patients undergoing either TSA or HA over a lifetime horizon to account for costs and medically important events over the patient lifetime. Subgroup analyses by age groups (≤50 or >50 years) were performed. A series of sensitivity analyses were performed to assess robustness of study findings. The results were presented in 2019 U.S. dollars. Results TSA was dominant as it was less costly ($115,785 compared with $118,501) and more effective (10.21 compared with 8.47 QALYs) than HA over a lifetime horizon. Changes to health utility values after TSA and HA had the largest impact on the cost-effectiveness findings. At a willingness-to-pay (WTP) threshold of $50,000 per QALY gained, HA was not found to be cost-effective. The probability that TSA was cost-effective was 100%. Conclusions Based on a WTP of $50,000 per QALY gained, from the perspective of Canada's publicly funded health-care system, TSA was found to be cost-effective in all patients, including those ≤50 years of age, compared with HA. Level of evidence Economic and Decision Analysis Level II. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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