Early cost estimating model for new bioabsorbable orthopedic implant candidates: A theoretical study

Figueiredo, Lígia; Makhni, Eric C.; Dierks, Meghan; Ferreira, Frederico Castelo; Finkelstein, Stan N.

doi:10.1016/j.jmbbm.2021.104731

Cited by 2 publications

(3 citation statements)

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“…The time frame was 2 years. This study reports a reference case based on a societal perspective, meaning that costs and health events are incorporated regardless of who pays and benefits [20]. Comparisons are made regarding incremental utilities, measured as quality‐adjusted life‐years (QALYs) and incremental costs.…”

Section: Methodsmentioning

confidence: 99%

“…This method focuses on the patient’s perspective and productivity lost due to illness or injury. Productivity costs are calculated as the product of total hours lost and the hourly wage [20]. It was assumed that a healthy person works 42 h per week, with a mean hourly wage of $27 (U.S. national average in 2019) [43], considering a societal perspective in an American setting.…”

Section: Methodsmentioning

confidence: 99%

“…However, the cost‐effectiveness potential of endoscopic FHL transfer remains to be evaluated. Early CEA is used to assess the likelihood of an intervention being cost‐effective in different prospective scenarios [20], which is particularly important when designing clinical trials or developing new techniques or devices. The main advantage of early CEAs is assessing potential cost savings while new technologies are still being developed or in the early stages of introduction, which may be used to guide investment, research, or healthcare decisions.…”

Section: Introductionmentioning

confidence: 99%

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Early analysis shows that endoscopic flexor hallucis longus transfer has a promising cost-effectiveness profile in the treatment of acute Achilles tendon ruptures

Diniz

Ferreira

Figueiredo³

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose Current options for treating an Achilles tendon rupture (ATR) include conservative and surgical approaches. Endoscopic lexor hallucis longus (FHL) transfer has been recently proposed to treat acute ruptures, but its cost-efectiveness potential remains to be evaluated. Therefore, the objective of this study was to perform an early cost-efectiveness analysis of endoscopic FHL transfer for acute ATRs, comparing the costs and beneits of current treatments from a societal perspective. Methods A conceptual model was created, with a decision tree, to outline the main health events during the treatment of an acute ATR. The model was parameterized using secondary data. A systematic review of the literature was conducted to gather information on the outcomes of current treatments. Data related to outcomes of endoscopic FHL transfers in acute Achilles ruptures was obtained from a single prospective study. Analysis was limited to the two irst years. The incremental cost-efectiveness ratio was the main outcome used to determine the preferred strategy. A willingness-to-pay threshold of $100,000 per quality-adjusted life-year was used. Sensitivity analyses were performed to determine whether changes in input parameters would cause signiicant deviation from the reference case results. Speciically, a probability sensitivity analysis was conducted using Monte Carlo simulations, and a one-way sensitivity analysis was conducted by sequentially varying each model parameter within a given range. Results For the reference case, incremental cost-efectiveness ratios exceeded the willingness-to-pay threshold for all the surgical approaches. Overall, primary treatment was the main cost driver. Conservative treatment showed the highest direct costs related to the treatment of complications. In the probabilistic sensitivity analysis, at a willingness-to-pay threshold of $100,000, open surgery was cost-efective in 50.9%, minimally invasive surgery in 55.8%, and endoscopic FHL transfer in 72% of the iterations. The model was most sensitive to parameters related to treatment utilities, followed by the costs of primary treatments. Conclusion Surgical treatments have a moderate likelihood of being cost-efective at a willingness-to-pay threshold of $100,000, with endoscopic FHL transfer showing the highest likelihood. Following injury, interventions to improve healthrelated quality of life may be better suited for improved cost-efectiveness. Level of evidence Level III.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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