Patients with unilateral transfemoral amputation treated with a percutaneous osseointegrated prosthesis. A cost-effectiveness analysis

• Aims: The aim of this study was to compare the cost-effectiveness of treatment with an osseointegrated percutaneous (OI-) prosthesis and a socket-suspended (S-) prosthesis for patients with a transfemoral amputation. Patients and Methods: A Markov model was developed to estimate the medical costs and changes in quality-adjusted life-years (QALYs) attributable to treatment of unilateral transfemoral amputation over a projected period of 20 years from a healthcare perspective. Data were collected alongside a prospective clinical study of 51 patients followed for two years. Results: OI-prostheses had an incremental cost per QALY gained of €83 374 compared with S-prostheses. The clinical improvement seen with OI-prostheses was reflected in QALYs gained. Results: were most sensitive to the utility value for both treatment arms. The impact of an annual decline in utility values of 1%, 2%, and 3%, for patients with S-prostheses resulted in a cost per QALY gained of €37 020, €24 662, and €18 952, respectively, over 20 years. Conclusion: From a healthcare perspective, treatment with an OI-prosthesis results in improved quality of life at a relatively high cost compared with that for S-prosthesis. When patients treated with S-prostheses had a decline in quality of life over time, the cost per QALY gained by OI-prosthesis treatment was considerably reduced.

Ämnesord

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)

Nyckelord

adult

Article

computer assisted tomography

cost effectiveness analysis

device infection

device removal

female

follow up

human

leg amputation

major clinical study

male

medical record

osseointegration

patient-reported outcome

preoperative evaluation

priority journal

prospective study

prosthesis loosening

quality adjusted life year

quality control procedures

Short Form 36

skin penetration

surgical patient

transfemoral amputation

amputation

cost benefit analysis

devices

economics

femur

limb prosthesis

Markov chain

middle aged

outcome assessment

procedures

prosthesis implantation

quality of life

rehabilitation

surgery

Sweden

Artificial Limbs

Cost-Benefit Analysis

Follow-Up Studies

Humans

Markov Chains

Outcome Assessment (Health Care)

Prospective Studies

Quality-Adjusted Life Years

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)