Journal article
The use of patient-reported outcome measures to guide referral for hip and knee arthroplasty: part 2: a cost-effectiveness analysis
- Abstract:
-
Aims To assess how the cost-effectiveness of total hip arthroplasty (THA) and total knee arthroplasty (TKA) varies with age, sex, and preoperative Oxford Hip or Knee Score (OHS/OKS); and to identify the patient groups for whom THA/TKA is cost-effective.
Methods We conducted a cost-effectiveness analysis using a Markov model from a United Kingdom NHS perspective, informed by published analyses of patient-level data. We assessed the cost-effectiveness of THA and TKA in adults with hip or knee osteoarthritis compared with having no arthroplasty surgery during the ten-year time horizon.
Results THA and TKA cost < £7,000 per quality-adjusted life-year (QALY) gained at all preoperative scores below the absolute referral thresholds calculated previously (40 for OHS and 41 for OKS). Furthermore, THA cost < £20,000/QALY for patients with OHS of ≤ 45, while TKA was cost-effective for patients with OKS of ≤ 43, since the small improvements in quality of life outweighed the cost of surgery and any subsequent revisions. Probabilistic and one-way sensitivity analyses demonstrated that there is little uncertainty around the conclusions.
Conclusion If society is willing to pay £20,000 per QALY gained, THA and TKA are cost-effective for nearly all patients who currently undergo surgery, including all patients at and above our calculated absolute referral thresholds.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
Actions
Access Document
- Files:
-
-
(Preview, Version of record, pdf, 703.0KB, Terms of use)
-
(Preview, Supplementary materials, pdf, 278.2KB, Terms of use)
-
- Publisher copy:
- 10.1302/0301-620X.102B7.BJJ-2019-0105.R2
Authors
- Publisher:
- British Editorial Society of Bone and Joint Surgery
- Journal:
- Bone and Joint Journal More from this journal
- Volume:
- 102-B
- Issue:
- 7
- Pages:
- 950–958
- Publication date:
- 2020-06-30
- Acceptance date:
- 2020-02-04
- DOI:
- EISSN:
-
2049-4408
- ISSN:
-
2049-4394
- Language:
-
English
- Keywords:
- Pubs id:
-
1084793
- Local pid:
-
pubs:1084793
- Deposit date:
-
2020-02-04
Terms of use
- Copyright holder:
- Dakin et al.
- Copyright date:
- 2020
- Rights statement:
- © 2020 Authors. This article is distributed under the terms of the Creative Commons Attribution Non-Commercial-No Derivatives 4.0 (CC BY-NC-ND 4.0) licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits the copying and redistribution of the work only, and provided the original author and source are credited.
If you are the owner of this record, you can report an update to it here: Report update to this record