Cost-effectiveness of balloon kyphoplasty in patients with symptomatic vertebral compression fractures in a UK setting
- O. StrömAffiliated withi3 InnovusMedical Management Center, Karolinska Institutet Email author
- , C. LeonardAffiliated withMedtronic Ltd
- , D. MarshAffiliated withRoyal National Orthopaedic Hospital
- , C. CooperAffiliated withMRC Epidemiology Resource Centre, University of SouthamptonInstitute of Musculoskeletal Sciences, University of Oxford
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Balloon kyphoplasty (BKP) is a procedure used to treat vertebral compression fractures (VCFs). We developed a cost-effectiveness model to evaluate BKP in United Kingsdom patients with hospitalised VCFs and estimated the cost-effectiveness of BKP compared to non-surgical management. The results indicate that BKP provides a cost-effective alternative for treating these patients.
VCFs of osteoporotic patients are associated with chronic pain, a reduction in health-related quality of life (QoL) and high healthcare costs. BKP is a minimally invasive procedure that has resulted in pain relief, vertebral body height-restoration, decreased kyphosis and improved physical functioning in patients with symptomatic VCFs. BKP was shown to improve health-related QoL in a 12-month interim analysis of a randomised phase-III trial.
The objectives of this study were to develop a Markov cost-effectiveness model to evaluate BKP in patients with painful hospitalised VCFs and to estimate the cost-effectiveness of BKP compared with non-surgical management in a UK setting. It was assumed that QoL-benefits found at 12 months linearly approached zero during another 2 years, and that patients receiving BKP warranted six fewer hospital bed days compared with patients given non-surgical management.
The procedure was associated with quality-adjusted life-years (QALY)-gains of 0.17 and cost/QALY-gains at £8,800. The results were sensitive to assumptions about avoided length of hospital-stay and persistence of kyphoplasty-related QoL-benefits.
In conclusion, the results indicate that BKP provides a cost-effective alternative for treating patients with hospitalised VCFs in a UK-setting.
KeywordsHTA Markov Osteoporosis QALY UK
- Cost-effectiveness of balloon kyphoplasty in patients with symptomatic vertebral compression fractures in a UK setting
Volume 21, Issue 9 , pp 1599-1608
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- 1. i3 Innovus, Stockholm, Sweden
- 2. Medical Management Center, Karolinska Institutet, Stockholm, Sweden
- 7. Klarabergsviadukten 90, hus D, 2 tr, 111 64, Stockholm, Sweden
- 3. Medtronic Ltd, Watford, UK
- 4. Royal National Orthopaedic Hospital, Stanmore, UK
- 5. MRC Epidemiology Resource Centre, University of Southampton, Southampton, UK
- 6. Institute of Musculoskeletal Sciences, University of Oxford, Oxford, UK