Cost-Effectiveness Analysis of Treatments for Vertebral Compression Fractures

Abstract

Among patients for whom surgical treatment was indicated, kyphoplasty was found to be cost effective, and perhaps even cost saving, compared with vertebroplasty. Even for the oldest patients (85 years of age and older), both interventions would be considered cost effective in terms of cost per life-year gained.

A Randomized Trial Comparing Balloon Kyphoplasty and Vertebroplasty for Vertebral Compression Fractures due to Osteoporosis

“…26 Cumulative evidence demonstrates that kyphoplasty and vertebroplasty provide better outcome than nonsurgical management in RCTs and meta-analyses 4,5,7,[9][10][11]27,28 and acceptable cost-effectiveness ratios. 11,[29][30][31] Several large retrospective studies using claims data, investigating BKP, VP, and nonsurgical management, provide additional evidence. [32][33][34][35] Although 2 blinded RCTs concluded that vertebroplasty was similar to a local anesthetic "sham" intervention, 36,37 these trials have several important limitations, including atypically broad inclusion criteria, allowance of chronic fractures, small sample size, and, in 1 study, high crossover, all of which preclude definitive conclusions.…”

A Randomized Trial of Balloon Kyphoplasty and Nonsurgical Management for Treating Acute Vertebral Compression Fractures

“…Within the current literature we have found several randomized clinical trials comparing either kyphoplasty or vertebroplasty to nonsurgical management (NSM),2–4,6,31–34 and several reports that compare the cost-effectiveness of these procedures compared with NSM 4,29,35–37. Thus, mounting evidence document the benefits of kyphoplasty and vertebroplasty over standard NSM.…”

Outcomes of vertebroplasty compared with kyphoplasty: a systematic review and meta-analysis

“…Ong et al 19 found that, despite higher initial treatment costs of kyphoplasty, vertebroplasty was less cost-effective due to increased utilization of medical resources (partly due to retreatment) in the postoperative period over the 2 years after surgery. Edidin et al 20 found that kyphoplasty was cost-effective—and perhaps even cost-saving—compared with vertebroplasty using Medicare claims data. Again, these cost-effectiveness analysis studies are from non-randomized populations and are subject to significant selection bias.…”