Cost utility modeling of early vs late total knee replacement in osteoarthritis patients

Mari, K.; Dégieux, P.; Mistretta, Frédéric; Guillemin, Françis; Richette, Pascal

doi:10.1016/j.joca.2016.07.013

Cited by 9 publications

(33 citation statements)

References 38 publications

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“…Bedair et al estimated that there would be a loss in net earnings between $70,000 and $106,000 by delaying KA by 1–10 years over nonoperative treatment 13. On the other hand, Mari et al did not find any support for early TKA over late TKA from a cost-utility perspective 16…”

Section: Discussionmentioning

confidence: 99%

<p>Cost-of-illness of knee osteoarthritis: potential cost savings by not undergoing arthroplasty within the first 2 years</p>

Ong¹,

Runa²,

Lau³

et al. 2019

CEOR

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PurposeAlthough knee arthroplasty (KA) is the largest source of hospitalization costs for knee osteoarthritis (OA), some studies have suggested reducing the use of “low-value” interventions, such as intra-articular hyaluronic acid (HA), to lower health care costs. However, those studies fail to consider that HA has demonstrated benefits in extending time to more costly KA or avoiding KA altogether. We evaluated 1) the overall knee OA costs (direct) within a 2-year period; 2) the relative contribution of HA and KA costs; 3) the direct cost savings from HA patients not undergoing KA.Patients and methodsKnee OA patients were identified from the Optum Clinformatics data set, which includes physician, facility, and pharmacy claims data from privately insured patients of all ages. Patients were stratified in the no HA, non-hylan G-F 20, and hylan G-F 20 cohorts. The cumulative costs (payer perspective) were evaluated for all knee OA-related claims (adjusted to Consumer Price Index Jan 2017$) for patients who had at least 2 years follow-up. Costs were stratified into various clinical categories.ResultsThe study cohort included 2,030,497 knee OA patients, of which 65,144 patients (3.2%) underwent KA. The cost of treating knee OA within the 2-year follow-up period was estimated to be $4.99 billion (B). The majority of the costs (69%) were attributed to KA patients (3.2% of patients). In all, 15.9% of the HA patients underwent KA within 2 years, but HA only contributed 1.7% to the total costs for these patients. The remaining 84.1% of HA patients did not undergo KA, which saved an estimated total of $1.54B (average $20,740 per patient) or 83.9%, after accounting for their non-KA therapies.ConclusionOur study estimated substantial cost savings through a large percentage of HA patients not undergoing KA. Although a fraction of patients moved on from their conservative therapy to undergo KA within the 2-year period, HA attributed to <2% of their total treatment costs.

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Section: Discussionmentioning

confidence: 99%

<p>Cost-of-illness of knee osteoarthritis: potential cost savings by not undergoing arthroplasty within the first 2 years</p>

Ong¹,

Runa²,

Lau³

et al. 2019

CEOR

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“…Only one other study of the cost-effectiveness of early compared with late TKR in osteoarthritis patients was identified, in France (33). Mari et al described the use of a wide range of nonpharmacological and pharmacological treatment options, for which probabilities of improvement in WOMAC pain scores were derived from the literature.…”

Section: Discussionmentioning

confidence: 99%

Cost-Utility Analysis of Private Contracting to Reduce Public Waiting Times for Joint Replacement Surgery

Karnon

Haghighi

Sajjad

et al. 2018

Int J Technol Assess Health Care

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“…Total joint replacement has demonstrated cost-effectiveness that limits surgery to the just the most severe of cases. [5][6][7][8] The evidences of efficacy of orthobiologics are also inconclusive and are certainly evolving. The compilations of studies, including randomized controlled trials, systematic reviews, and meta-analyses completed to date are nothing short of impressive as many of these investigations have come without institutional support, and have been carried out over a relatively short period of time.…”

Section: Editorial E6mentioning

confidence: 99%

Orthobiologics: Filling the Gaps in Current Orthopaedic Surgical Treatment

Murrell

2021

Bio Orthop J

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Cost utility modeling of early vs late total knee replacement in osteoarthritis patients

Abstract: Our data do not support the early TKR strategy over the late TKR strategy in knee OA patients from a medico-economic perspective.

Cited by 9 publications

References 38 publications

<p>Cost-of-illness of knee osteoarthritis: potential cost savings by not undergoing arthroplasty within the first 2 years</p>

<p>Cost-of-illness of knee osteoarthritis: potential cost savings by not undergoing arthroplasty within the first 2 years</p>

Cost-Utility Analysis of Private Contracting to Reduce Public Waiting Times for Joint Replacement Surgery

Orthobiologics: Filling the Gaps in Current Orthopaedic Surgical Treatment

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