Do tariffs and prices correspond with costs? A case study of orthotic braces

Simoens, Steven; Debruyne, Hans; Moldenaers, Ingrid; Guillaume, Patrick; Coster, Sandra De; Steen, Dirk Van den; Sande, Stefaan Van de; Ramaekers, Dirk; Lona, Murielle

doi:10.3111/13696990802078845

Cited by 2 publications

(5 citation statements)

References 7 publications

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“…The study estimated neck braces to cost between 55 and 150 euros (€) and knee braces to be between €331 and €694. These smaller ranges of cost estimates highlight that there was less uncertainty in Simeons et al's analysis, 71 given their increased data on the manufacturing costs of these devices.…”

Section: Costing Analysismentioning

confidence: 99%

“…Such analysis would need to involve device manufacturers and suppliers of KAFO components/raw materials. Raw material and production costs would need to be estimated in more detail; the methodology used by Simeons et al 71 provides an initial framework to conduct such an analysis. 71 was able to obtain more detailed manufacturing and production costs.…”

Section: Costing Analysismentioning

confidence: 99%

“…Raw material and production costs would need to be estimated in more detail; the methodology used by Simeons et al 71 provides an initial framework to conduct such an analysis. 71 was able to obtain more detailed manufacturing and production costs. The study estimated neck braces to cost between 55 and 150 euros (€) and knee braces to be between €331 and €694.…”

Section: Costing Analysismentioning

confidence: 99%

“…The methodology used below follows that of Simoens et al 71 The aim of this paper 71 was to develop a model that calculates the cost of production and distribution of orthotic braces. The paper began by estimating the cost of production of knee and neck braces and overheads.…”

Section: Cost Estimates For Knee-ankle-foot Orthosesmentioning

confidence: 99%

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Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: systematic review, qualitative study, survey and costing analysis

O’Connor

McCaughan

McDaid

et al. 2016

Health Technol Assess

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BackgroundPatients who have knee instability that is associated with neuromuscular disease (NMD) and central nervous system (CNS) conditions can be treated using orthoses, such as knee–ankle–foot orthoses (KAFOs).ObjectivesTo assess existing evidence on the effectiveness of orthoses; patient perspectives; types of orthotic devices prescribed in the UK NHS; and associated costs.MethodsQualitative study of views of orthoses users – a qualitative in-depth interview study was undertaken. Data were analysed for thematic content. A coding scheme was developed and an inductive approach was used to identify themes. Systematic review – 18 databases were searched up to November 2014: MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, Cumulative Index to Nursing and Allied Health, EMBASE, PASCAL, Scopus, Science Citation Index, BIOSIS Previews, Physiotherapy Evidence Database, Recal Legacy, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Health Technology Assessment database, Cochrane Central Register of Controlled Trials, Conference Proceedings Citation Index: Science, Health Management Consortium, ClinicalTrials.gov, International Clinical Trials Registry Platform and National Technical Information Service. Studies of adults using an orthosis for instability of the knee related to NMD or a CNS disorder were included. Data were extracted and quality was assessed by two researchers. Narrative synthesis was undertaken. Survey and costing analysis – a web survey of orthotists, physiotherapists and rehabilitation medicine physicians was undertaken. Telephone interviews with orthotists informed a costing analysis.ResultsQualitative study – a total of 24 people participated. Potential for engagement in daily activities was of vital importance to patients; the extent to which their device enabled this was the yardstick by which it was measured. Patients’ prime desired outcome was a reduction in pain, falls or trips, with improved balance and stability. Effectiveness, reliability, comfort and durability were the most valued features of orthoses. Many expressed frustration with perceived deficiencies in service provision relating to appointment and administrative systems and referral pathways. Systematic review – a total of 21 studies (478 participants) were included of people who had post-polio syndrome, inclusion body myositis, were post stroke or had spinal cord injury. The studies evaluated KAFOs (mainly carbon fibre), stance control KAFO and hip KAFOs. All of the studies were at risk of bias and, in general, were poorly reported. Survey and costing analysis – in total, 238 health-care professionals responded. A range of orthoses is prescribed for knee instability that is related to NMD or CNS conditions, approximately half being custom-made. At least 50% of respondents thought that comfort and confidence in mobility were extremely important treatment outcomes. The cost of individual KAFOs was highly variable, ranging from £73 to £3553.ConclusionsVarious types of orthoses are used in the NHS to manage patients with NMD/CNS conditions and knee instability, both custom-made and prefabricated, of variable cost. Evidence on the effectiveness of the orthoses is limited, especially in relation to the outcomes that are important to orthoses users.LimitationsThe population included was broad, limiting any in-depth consideration of specific conditions. The response rate to the survey was low, and the costing analysis was based on some assumptions that may not reflect the true costs of providing KAFOs.Future workFuture work should include high-quality research on the effectiveness and cost-effectiveness of orthoses; development of a core set of outcome measures; further exploration of the views and experiences of patients; and the best models of service delivery.Study registrationThis study is registered as PROSPERO CRD42014010180. The qualitative study is registered as Current Controlled Trials ISRCTN65240228.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Costing Analysismentioning

confidence: 99%

Section: Costing Analysismentioning

confidence: 99%

Section: Costing Analysismentioning

confidence: 99%

Section: Cost Estimates For Knee-ankle-foot Orthosesmentioning

confidence: 99%

See 2 more Smart Citations

Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: systematic review, qualitative study, survey and costing analysis

O’Connor

McCaughan

McDaid

et al. 2016

Health Technol Assess

View full text Add to dashboard Cite

show abstract

“…Embora não existam estudos comparando diferenças na prescrição de órteses entre países desenvolvidos e em desenvolvimento, a ausência de financiamento adequado por parte de agentes de saúde públicos e privados poderia contribuir para o aumento do custo de órteses pré-fabricadas (131), comprometendo o desenvolvimento e manutenção de um mercado consistente de órteses, além da quantidade de modelos disponíveis a pacientes e profissionais.…”

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Influência do uso de órteses para osteoartrite do polegar : análise cinemática e funcional

Almeida¹

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Do tariffs and prices correspond with costs? A case study of orthotic braces

Abstract: Actual retail prices and reimbursement tariffs for a neck brace and a knee brace exceeded prices based on estimated costs. Therefore, there appears to be scope for reducing tariffs.

Cited by 2 publications

References 7 publications

Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: systematic review, qualitative study, survey and costing analysis

Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: systematic review, qualitative study, survey and costing analysis

Influência do uso de órteses para osteoartrite do polegar : análise cinemática e funcional

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