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- Geale, KirkUmeå universitet,Avdelningen för medicin,PAREXEL International, Stockholm, Sweden (author)
Budget impact analysis of demineralized bone matrix in combination with autograft in lumbar spinal fusion procedures for the treatment of lumbar degenerative disc disease in Spain
- Article/chapterEnglish2018
Publisher, publication year, extent ...
- 2018-07-05
- Taylor & Francis,2018
- printrdacarrier
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- LIBRIS-ID:oai:DiVA.org:umu-153845
- https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-153845URI
- https://doi.org/10.1080/13696998.2018.1489256DOI
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- Language:English
- Summary in:English
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- Objective: To estimate the budget impact (BI) of introducing local autograft (LA) combined with demineralized bone matrix (LA + DBM) in lumbar spinal fusion (LSF) procedures to treat lumbar degenerative disc disease (LDDD) in Spain.Methods: A decision tree model was developed to evaluate the 4-year BI associated with introducing LA + DBM putty to replace currently available grafting methods, including iliac crest bone graft (ICBG), LA alone, and LA combined with beta-tricalcium phosphate (LA + ceramics), with 30%, 40%, and 30% market shares, respectively. The analysis was conducted for a hypothetical cohort of 100 patients with LDDD receiving LSF, assuming LA + DBM would replace 100% of the standard of care mix. The fusion rates extracted from the literature were validated by an expert panel. Costs ((sic)2017) were obtained from different Spanish sources. Budget impact and incremental cost per successful fusion were calculated from the perspective of the Spanish National Health System (NHS).Results: Over 4 years, replacing currently available options with LA + DBM for 100 patients resulted in an additional cost of (sic)12,330 ((sic)123/patient), and an additional 14 successful fusions, implying a cost of (sic)881 per additional successful fusion. When costs of productivity loss were included, the introduction of LA + DBM resulted in cost savings of (sic)70,294 ((sic)703/patient).Limitations: The lack of high-quality, homogeneous, head-to-head research studying the efficacy of grafting procedures available to patients undergoing LSF, in addition to a lack of long-term follow-up in existing studies. Therefore, the number of fusions occurring within the model's time horizon may be underestimated.Conclusions: Acquisition costs of DBM were partially offset by costs of failed fusions, adverse events and reoperation when switching 100 hypothetical LDDD patients undergoing LSF procedures from standard of care grafting methods to LA + DBM from the perspective of the Spanish NHS. DBM cost was entirely offset when costs of lost productivity were considered.
Subject headings and genre
- MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi hsv//swe
- MEDICAL AND HEALTH SCIENCES Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy hsv//eng
- Budget impact
- health economics
- cost
- demineralized bone matrix
- lumbar degenerative disc disease
- lumbar spinal fusion
- Spain
Added entries (persons, corporate bodies, meetings, titles ...)
- Alvarez, Maria (author)
- Polyzoi, Maria (author)
- Malaga, Xavier (author)
- Pineda, Cristina (author)
- Hernandez, Cesar (author)
- Umeå universitetAvdelningen för medicin (creator_code:org_t)
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- In:Journal of Medical Economics: Taylor & Francis21:10, s. 977-9821369-69981941-837X
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