Cost Comparison of Socket-Suspended and Bone-Anchored Transfemoral Prostheses

Abstract

Introduction This observational study compared historical costs for provision of socket prostheses with simulated costs for bone-anchored prostheses (BAPs). Materials and Methods The costs of transfemoral socket prostheses and BAP were extracted from the Queensland Artificial Limb Service's regulatory documentation according to K-levels and estimated for low-cost, budget, and high-cost limb options. Total costs including labor and parts after 6-year funding cycles were cross-compared for each socket and BAP fitting option. Results Labor and attachment costs were reduced by 18% and 79%, respectively, for all BAP options compared with any socket fitting. BAP was more economical by $18,200, $7,000, and $1,600 when fitted with low-cost, budget, and high-cost options, respectively, compared with sockets for K4. The low-cost limb was the only economical option compared with all sockets above K2. Other BAP options were uneconomical compared with socket fitting below K4. Discussion Suppliers of conventional prosthetic components can strongly impact the overall costs. Interestingly, manufacturers of BAP could play a decisive role given the cost of specific parts (e.g., connectors, protective devices). Conclusions The proposed approach for cost assessments could assist funding organizations worldwide working toward the development of fair and equitable financial assistance programs for individuals choosing BAP.

Automated Characterization of Anthropomorphicity of Prosthetic Feet Fitted to Bone-Anchored Transtibial Prosthesis

“…[23,24,[30][31][32][33][34][35] Altogether, stiffness characterization might also assist in the development of specific guidelines for design and prescription of feet and ankle units for transtibial prostheses, the sole loading elements under the control of prosthetists that is also subjected to cost-benefit analyses by funders. [36,37]…”

A Short Review on the Cost, Design, Materials and Challenges of the Prosthetics Leg Development and Usage

“…In comparison to socket suspended, BAP is proven to possess more beneficial criteria in terms of quality of life, user-ease, osseoperception, ability of gait and sustained extended daily activities. However, it is infamously known for its clinical risks where it is susceptible toward infection, implant instability, effect of falling and breakage of fixation parts [16].…”

“…Meanwhile, according to a study conducted by American researchers, the price of regular custom made manufacturing socket-suspended prosthesis is around $6,203 to $20,070. In Australia, the interim prosthesis cost is less than $2,000 and BAP cost is fixed at around $3,000 [16]. The prices mentioned are the average cost of prosthetic leg in Malaysia, Italy and Australia.…”

Development of a Government Continuous Quality Improvement Procedure for Assessing the Provision of Bone Anchored Limb Prosthesis: A Process Re-Design Descriptive Study

“…(29) Furthermore, cost cross-comparing and cost-effectiveness demonstrated health economic benefits of BAP over SSP from government perspective. (30)(31)(32) For instance, provision of BAP costed 21±41% more but increased quality-adjusted life-year by 17±5% compared to SSP leading to an indicative incremental cost effectiveness ratio of approximately AUD $17,000 per quality-adjusted life-year. Despite a partial compensation of the cost by quality-adjusted life-year, the provision of BAP was deemed cost-effective since the incremental cost effectiveness ratio was noticeably below willingness to pay threshold.…”

“…With a yearly budget of AUD$5.4 million, QALS provides equitable funding for prosthetic services to 3,600 active consumers annually through a network of up to 10 individual prosthetists referred to as Prosthetic Service Provider (PSP). (29,30,33)…”