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Cost-effectiveness of Birmingham Hip Resurfacing compared to Total Hip Replacement

Heintzbergen, Sanne (2011) Cost-effectiveness of Birmingham Hip Resurfacing compared to Total Hip Replacement.

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Abstract:Objective: The purpose of this study was to investigate the cost-effectiveness of metal-on-metal Birmingham Hip Resurfacing (MoM BHR) versus ceramic-on-ceramic Total Hip Replacement (CoC THR), in younger OA patients, with use of decision analytic modelling considering the long term effects. Methods: A Markov decision analytic model was constructed to compare the quality-adjusted-life years (QALYs) and costs of MoM BHR versus CoC THR in a 15-year time horizon and from a healthcare perspective. Sensitivity analyses were performed to explore the robustness of the decision analytic model. The main outcome measure is the incremental cost effectiveness ratios (ICERs). Results: Estimates based on the model show that patients receiving a MoM BHR experience lower effectiveness, presented as less QALYs, and have lower health care costs compared to CoC THR patients. The ICER of CDN $ 35303/QALY calculated from lower gains in QALYs with lower health care costs will not necessarily be considered cost-effective. Subgroup analysis showed that MoM BHR was associated with higher effectiveness, lower costs and therefore cost savings both for females younger than 50 years of age and males younger than 60 years of age. Initial costs for MoM BHR and CoC THR and the utility post first revision MoM BHR had the largest impact on the results found. Conclusions: The results of this study confirm results reported in other studies that MoM BHR is cost-effective or cost savings for females younger than 50 years of age and males younger than 60 years of age. In the base case analysis, probability that MoM BHR is cost-effective compared to CoC THR is only 53% with a willingness-to-pay of $50,000.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:88 social and public administration
Programme:Health Sciences MSc (66851)
Link to this item:https://purl.utwente.nl/essays/62844
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