Cost‐Effectiveness of the Ponseti Method for Treatment of Clubfoot in Pakistan

Hussain, Hamidah; Burfat, Aziza; Samad, Lubna; Jawed, Fayez; Chinoy, Muhammad Amin; Khan, Mansoor A.

doi:10.1007/s00268-014-2530-2

Cited by 21 publications

(24 citation statements)

References 25 publications

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“…Total charges that we incurred on each patient amounted to 71 USD, which was comparatively less than for the Turcos procedure charges of 96 USD and very affordable for the patients’ families ( Table 6 ). Our findings in this regard were similar to the studies by Gadhok et al, Ferreira et al and Hussain et al [ 22 , 32 , 33 ]. Since our study group consisted of patients coming from low-income backgrounds in rural areas, cost was a very important variable for the success of the treatment.Grimes CT et al [ 34 ] in their study also stated that the Ponseti method for the treatment of club foot is cost-effective and practical in a low-income country setting.…”

Section: Discussionsupporting

confidence: 93%

Ponseti Technique for the Management of Congenital Talipes Equinovarus in a Rural Set-Up in India: Experience of 356 Patients

Malhotra

Mohapatra²,

Arora

et al. 2018

Children

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Congenital talipes equinovarus (CTEV), also known as clubfoot, is a complex congenital deformity of the foot that, left untreated, can limit a person’s mobility by making it difficult and painful to walk. Worldwide, 80% of children born with clubfoot are in low- and middle-income countries. The management of clubfoot has a long history. Non-operative management did not become popular, as an increasing number of orthopaedists started leaning towards surgical treatment. The late Dr. Ignacio Ponseti developed a method of clubfoot correction that successfully realigns clubfoot in infants without extensive and major surgery. The aim of the study was to assess the functional outcome of CTEV management by the Ponseti technique, to study the severity of CTEV deformity using the Pirani score, and to evaluate the cost-effectiveness of the technique. A total of 356 cases with 402 feet with CTEV were treated by the Ponseti method. The average age of the children and the number of casts applied before full correction were 4.03 months and 6.91, respectively. There was a good functional outcome in 95.45% of cases (score > 30) at the last follow up. The management of CTEV by the Ponseti technique provides a good functional and cosmetic outcome. In a developing country like India, this technique is a safe, easy, economical method of clubfoot management.

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Section: Discussionsupporting

confidence: 93%

Ponseti Technique for the Management of Congenital Talipes Equinovarus in a Rural Set-Up in India: Experience of 356 Patients

Malhotra

Mohapatra²,

Arora

et al. 2018

Children

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“…We performed a sensitivity analysis by replacing our cost estimate with a previously published estimate of the cost of treatment with the Ponseti method in Pakistan; 34 using the same disability weight across unilateral and bilateral CTEV; and eliminating the discounting and introducing age weighting, a factor that gives a higher value to years lived as an adult than childhood, as proposed in the WHO guidelines on cost-effectiveness analysis. 33 The range from minimum to maximum cost-effectiveness ratios derived from sensitivity analysis was tabulated along with the average cost-effectiveness ratio.…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of club-foot treatment in low-income and middle-income countries by the Ponseti method

et al. 2016

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BackgroundClub foot is a common congenital deformity affecting 150 000–200 000 children every year. Untreated patients end up walking on the side or back of the affected foot, with severe social and economic consequences. Club foot is highly treatable by the Ponseti method, a non-invasive technique that has been described as highly suitable for use in resource-limited settings. To date, there has been no evaluation of its cost-effectiveness ratio, defined as the cost of averting one disability-adjusted life year (DALY), a composite measure of the impact of premature death and disability. In this study, we aimed to calculate the average cost-effectiveness ratio of the Ponseti method for correcting club foot in sub-Saharan Africa.MethodsUsing data from 12 sub-Saharan African countries provided by the international non-profit organisation CURE Clubfoot, which implements several Ponseti treatment programmes around the world, we estimated the average cost of the point-of-care treatment for club foot in these countries. We divided the cost of treatment with the average number of DALYs that can be averted by the Ponseti treatment, assuming treatment is successful in 90% of patients.ResultsWe found the average cost of the Ponseti treatment to be US$167 per patient. The average number of DALYs averted was 7.42, yielding a cost-effectiveness ratio of US$22.46 per DALY averted. To test the robustness of our calculation different variables were used and these yielded a cost range of US$5.28–29.75. This is less than a tenth of the cost of many other treatment modalities used in resource-poor settings today.ConclusionsThe Ponseti method for the treatment of club foot is cost-effective and practical in a low-income country setting. These findings could be used to raise the priority for implementing Ponseti treatment in areas where patients are still lacking access to the life-changing intervention.

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“…In the study of Hussain, H. and others., cost of the two clubfoot treatment methods were compared. The survey shows that the average cost of surgical method is more than twice higher than the average cost of treatment with Ponseti method [30]. There were statistically significant differences in all negative traits of the Ponseti and the Turco methods.…”

Section: Discussionmentioning

confidence: 93%

Comparison of two treatment methods of congenital clubfoot in the orthopaedists’ opinion

Okoński¹,

Misztal-Okońska

Okoński

et al. 2017

Polish Journal of Public Health

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Introduction. Clubfoot is the second most common birth defect of the lower limb. In Europe (including Poland) it concerns about 1-2 in 1000 newborns. What is characteristic for a clubfoot, is change in the foot shape and its impairment with preserving anatomical structures. Aim. The aim of this work is to gather opinions of orthopedic physicians on the effectiveness of the two methods used to treat congenital clubfoot: the Turco method and the Ponseti method. Material and methods. The research method used in the work was a diagnostic survey and research technique was the author’s questionnaire designed to gather opinions of orthopedic surgeons on the two methods of clubfoot treatment. The questionnaires were collected in the Orthopaedic Clinics in Lublin and Rzeszów, as well as during the specialization courses for orthopaedic surgeons in Lublin. Results. The most important advantages of the Ponseti method according to respondents are high clinical effectiveness (average 4.48) and short duration of hospitalization (average 4.31). While the most important disadvantages of the method is length of rehabilitation (average 2.85) and convalescence (average 2.36). Top assets of the Turco method in turn, according to respondents, are high clinical efficiency (average 2.92) and certainty of the patient’s recovery (2.74). In turn, the downsides of the Turco method according to the respondents are high invasiveness (average 4.11) and length of convalescence (average 3.87). Conclusion. The Ponseti method is the surveyed doctors’ preferred method of congenital clubfoot treatment.

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Cost‐Effectiveness of the Ponseti Method for Treatment of Clubfoot in Pakistan

Abstract: The Ponseti method is clearly the treatment of choice in resource-constrained settings like Pakistan. Household costs for clubfoot treatment are substantial, even in programs offering free diagnostics and treatments and may be a barrier to service utilization for the poorest patients.

Cited by 21 publications

References 25 publications

Ponseti Technique for the Management of Congenital Talipes Equinovarus in a Rural Set-Up in India: Experience of 356 Patients

Ponseti Technique for the Management of Congenital Talipes Equinovarus in a Rural Set-Up in India: Experience of 356 Patients

Cost-effectiveness of club-foot treatment in low-income and middle-income countries by the Ponseti method

Comparison of two treatment methods of congenital clubfoot in the orthopaedists’ opinion

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