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Abstract
Background
The aim of this study was to perform a cost-utility analysis for total knee arthroplasty (TKA) over a 10-year follow up period.
Methods
Two-hundred and twelve patients were randomised to receive either a Kinemax or a Triathlon TKA. Patients were assessed pre-operatively, and at 6 months, and 1, 3, 7 and 10 years postoperatively. The costs of the primary and revision surgery were accounted for. One-year quality-adjusted life year (QALY) gain was used to estimate 10-year gains using the established annual health gain discounts.
Results
Forty-eight patients died and eight were revised during the follow up period. Overall QALY gain per patient over the 10-year period was 2.594 and the cost per patient was £6559, which resulted in a cost per QALY of £2761 at 10 years. The Triathlon group had a significantly greater QALY gain compared with the Kinemax (mean difference (MD) 0.53, 95% CI 0.03–1.03, P = 0.02), which resulted in a cost per QALY for the Triathlon group of £2521 compared with £3107 for the Kinemax group at 10 years. The 5% annual discount resulted in a significantly lower QALY gain (MD 0.135, 95% CI 0.201–0.354, P = 0.002), whereas the 3.5% annual discount resulted in non-significant difference in QALY gain compared with the actual gain (MD 0.021, 95% CI −0.084 to 0.077, P = 0.292).
Conclusions
TKA was a cost-effective intervention, and the Triathlon was associated with a greater cost effectiveness at 10 years. The 3.5% annual discounts for QALY gain would seem to be the most accurate, with an underestimation being observed with the 5% discount.
The aim of this study was to perform a cost-utility analysis for total knee arthroplasty (TKA) over a 10-year follow up period.
Methods
Two-hundred and twelve patients were randomised to receive either a Kinemax or a Triathlon TKA. Patients were assessed pre-operatively, and at 6 months, and 1, 3, 7 and 10 years postoperatively. The costs of the primary and revision surgery were accounted for. One-year quality-adjusted life year (QALY) gain was used to estimate 10-year gains using the established annual health gain discounts.
Results
Forty-eight patients died and eight were revised during the follow up period. Overall QALY gain per patient over the 10-year period was 2.594 and the cost per patient was £6559, which resulted in a cost per QALY of £2761 at 10 years. The Triathlon group had a significantly greater QALY gain compared with the Kinemax (mean difference (MD) 0.53, 95% CI 0.03–1.03, P = 0.02), which resulted in a cost per QALY for the Triathlon group of £2521 compared with £3107 for the Kinemax group at 10 years. The 5% annual discount resulted in a significantly lower QALY gain (MD 0.135, 95% CI 0.201–0.354, P = 0.002), whereas the 3.5% annual discount resulted in non-significant difference in QALY gain compared with the actual gain (MD 0.021, 95% CI −0.084 to 0.077, P = 0.292).
Conclusions
TKA was a cost-effective intervention, and the Triathlon was associated with a greater cost effectiveness at 10 years. The 3.5% annual discounts for QALY gain would seem to be the most accurate, with an underestimation being observed with the 5% discount.
Original language | English |
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Pages (from-to) | 79-98 |
Journal | The Knee |
Volume | 44 |
DOIs | |
Publication status | Published - 3 Aug 2023 |
Keywords / Materials (for Non-textual outputs)
- Total knee arthroplasty
- Cost-utility
- Implant
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Dive into the research topics of 'Cost utility analysis of total knee arthroplasty using 10-year data from a randomised controlled trial: Implant design influences quality - adjusted life year gain'. Together they form a unique fingerprint.Projects
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Edinburgh Orthopaedic Relational Database
MacDonald, D., Simpson, H., Yapp, L. & Clement, N.
1/01/20 → 31/12/25
Project: Research