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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2013

01.11.2013 | Knee

Cost-effectiveness and economic impact of the KineSpring® Knee Implant System in the treatment for knee osteoarthritis

verfasst von: Chuan Silvia Li, Thomas Seeger, Thomas C. Auhuber, Mohit Bhandari

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 11/2013

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Abstract

Purpose

To investigate the cost-effectiveness and economic impact of the KineSpring System in the treatment for knee osteoarthritis in Germany.

Methods

Functional outcome scores of the general German population and knee osteoarthritis (OA) patients under surgical treatments (HTO, UKA and TKA), conservative treatments and treatment with the KineSpring System were used to derive the utility scores for each group. Quality-adjusted life years (QALYs) of each group were estimated using the utility scores. Finally, cost-utility analysis was performed using cost and QALYs data. The economic impact of knee OA in Germany was assessed in terms of annual total direct cost and indirect cost, total diseased population and potential QALYs saved with the KineSpring System.

Results

Assuming the durability of 10 years, the cost-utility ratio of the KineSpring System, surgical treatments and conservative treatments compared to no treatment in 2012 was €3,402/QALY, €4,899/QALY and €9,996/QALY, respectively. With even a lesser durability of 5 years, the cost-utility ratio of the KineSpring System maintained superiority over surgical treatments and conservative treatments (€7,327/QALY, €9,706/QALY and €10,467/QALY, respectively). The KineSpring System is a highly cost-effective alternative for knee osteoarthritis compared with the current accepted cost-effective threshold (willingness to pay) of $50,000 US/QALY gained. Our models suggest KineSpring System, if adapted widely could save up to 2.0 ± 0.07 million QALY assuming it has a 5-year durability and save up to 3.9 ± 0.1 million QALY assuming it has a 10-year durability.

Conclusion

An economic advantage for using the KineSpring System over other surgical and conservative treatments in knee OA patients in Germany is suggested by our model. According to currently accepted cost-effectiveness guidelines, the KineSpring Knee Implant System for knee OA is a cost-effective strategy.

Level of evidence

Cost-effectiveness analysis, Level III.
Literatur
1.
Zurück zum Zitat Albertsen PC, Nease RF Jr, Potosky AL (1998) Assessment of patient preferences among men with prostate cancer. J Urol 159:158–163PubMedCrossRef Albertsen PC, Nease RF Jr, Potosky AL (1998) Assessment of patient preferences among men with prostate cancer. J Urol 159:158–163PubMedCrossRef
3.
Zurück zum Zitat Bohm P, Holy T, Pietsch-Breitfeld B, Meisner C (2000) Mortality after total knee arthroplasty in patients with osteoarthrosis and rheumatoid arthritis. Arch Orthop Trauma Surg 120:75–78PubMed Bohm P, Holy T, Pietsch-Breitfeld B, Meisner C (2000) Mortality after total knee arthroplasty in patients with osteoarthrosis and rheumatoid arthritis. Arch Orthop Trauma Surg 120:75–78PubMed
4.
Zurück zum Zitat Clifford A, O’Connell M, Gabriel S, Miller LE, Block JE (2011) The KineSpring load absorber implant: rationale, design and biomechanical characterization. J Med Eng Technol 35:65–71PubMedCrossRef Clifford A, O’Connell M, Gabriel S, Miller LE, Block JE (2011) The KineSpring load absorber implant: rationale, design and biomechanical characterization. J Med Eng Technol 35:65–71PubMedCrossRef
5.
Zurück zum Zitat Culliford DJ, Maskell J, Beard DJ, Murray DW, Price AJ, Arden NK (2010) Temporal trends in hip and knee replacement in the United Kingdom: 1991 to 2006. J Bone Joint Surg Br 92:130–135PubMed Culliford DJ, Maskell J, Beard DJ, Murray DW, Price AJ, Arden NK (2010) Temporal trends in hip and knee replacement in the United Kingdom: 1991 to 2006. J Bone Joint Surg Br 92:130–135PubMed
7.
Zurück zum Zitat Dominick KL, Ahern FM, Gold CH, Heller DA (2004) Health-related quality of life among older adults with arthritis. Health Qual Life Outcomes 2:5PubMedCrossRef Dominick KL, Ahern FM, Gold CH, Heller DA (2004) Health-related quality of life among older adults with arthritis. Health Qual Life Outcomes 2:5PubMedCrossRef
8.
Zurück zum Zitat Feeny D, Blanchard C, Mahon JL, Bourne R, Rorabeck C, Stitt L, Webster-Bogaert S (2003) Comparing community-preference-based and direct standard gamble utility scores: evidence from elective total hip arthroplasty. Int J Technol Assess 19:362–372CrossRef Feeny D, Blanchard C, Mahon JL, Bourne R, Rorabeck C, Stitt L, Webster-Bogaert S (2003) Comparing community-preference-based and direct standard gamble utility scores: evidence from elective total hip arthroplasty. Int J Technol Assess 19:362–372CrossRef
9.
Zurück zum Zitat Feeny D, Furlong W, Saigal S, Sun J (2004) Comparing directly measured standard gamble scores to HUI2 and HUI3 utility scores: group- and individual-level comparisons. Soc Sci Med 58:799–809PubMedCrossRef Feeny D, Furlong W, Saigal S, Sun J (2004) Comparing directly measured standard gamble scores to HUI2 and HUI3 utility scores: group- and individual-level comparisons. Soc Sci Med 58:799–809PubMedCrossRef
10.
Zurück zum Zitat Feeny D, Townsend M, Furlong W, Tomkins DJ, Robinson GE, Torrance GW, Mohide PT, Wang Q (2000) Assessing health-related quality-of-life in prenatal diagnosis comparing Chorionic Villi Sampling and Amniocentesis: a technical report. Center for Health Economics and Policy Analysis, McMaster University, Hamilton Feeny D, Townsend M, Furlong W, Tomkins DJ, Robinson GE, Torrance GW, Mohide PT, Wang Q (2000) Assessing health-related quality-of-life in prenatal diagnosis comparing Chorionic Villi Sampling and Amniocentesis: a technical report. Center for Health Economics and Policy Analysis, McMaster University, Hamilton
11.
Zurück zum Zitat Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF (1987) The prevalence of knee osteoarthritis in the elderly. The Framingham osteoarthritis study. Arthritis Rheum 30:914–918PubMedCrossRef Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF (1987) The prevalence of knee osteoarthritis in the elderly. The Framingham osteoarthritis study. Arthritis Rheum 30:914–918PubMedCrossRef
12.
Zurück zum Zitat Furlong W, Feeny D, Torrance GW, Goldsmith C, DePauw S, Zhu Z, Denton M, Boyle M (1998) Multiplicative multi-attribute utility function for the health utilities index mark 3 (HUI3) system: a technical report. Center for Health Economics and Policy Analysis, McMaster University, Hamilton Furlong W, Feeny D, Torrance GW, Goldsmith C, DePauw S, Zhu Z, Denton M, Boyle M (1998) Multiplicative multi-attribute utility function for the health utilities index mark 3 (HUI3) system: a technical report. Center for Health Economics and Policy Analysis, McMaster University, Hamilton
13.
Zurück zum Zitat Gabriel SE, Kneeland TS, Melton LJ 3rd, Moncur MM, Ettinger B, Tosteson AN (1999) Health-related quality of life in economic evaluations for osteoporosis: whose values should we use? Med Decis Making 19:141–148PubMedCrossRef Gabriel SE, Kneeland TS, Melton LJ 3rd, Moncur MM, Ettinger B, Tosteson AN (1999) Health-related quality of life in economic evaluations for osteoporosis: whose values should we use? Med Decis Making 19:141–148PubMedCrossRef
15.
Zurück zum Zitat Grootendorst P, Marshall D, Pericak D, Bellamy N, Feeny D, Torrance GW (2007) A model to estimate health utilities index mark 3 utility scores from WOMAC index scores in patients with osteoarthritis of the knee. J Rheumatol 34:534–542PubMed Grootendorst P, Marshall D, Pericak D, Bellamy N, Feeny D, Torrance GW (2007) A model to estimate health utilities index mark 3 utility scores from WOMAC index scores in patients with osteoarthritis of the knee. J Rheumatol 34:534–542PubMed
16.
Zurück zum Zitat Gupta S, Hawker GA, Laporte A, Croxford R, Coyte PC (2005) The economic burden of disabling hip and knee osteoarthritis (OA) from the perspective of individuals living with this condition. Rheumatology (Oxford) 44:1531–1537CrossRef Gupta S, Hawker GA, Laporte A, Croxford R, Coyte PC (2005) The economic burden of disabling hip and knee osteoarthritis (OA) from the perspective of individuals living with this condition. Rheumatology (Oxford) 44:1531–1537CrossRef
17.
Zurück zum Zitat Hermans J, Koopmanschap MA, Bierma-Zeinstra SM, van Linge JH, Verhaar JA, Reijman M, Burdorf A (2012) Productivity costs and medical costs among working patients with knee osteoarthritis. Arthritis Care Res (Hoboken) 64:853–861CrossRef Hermans J, Koopmanschap MA, Bierma-Zeinstra SM, van Linge JH, Verhaar JA, Reijman M, Burdorf A (2012) Productivity costs and medical costs among working patients with knee osteoarthritis. Arthritis Care Res (Hoboken) 64:853–861CrossRef
18.
Zurück zum Zitat ICD-10-GM: M15-M19 Osteoarthritis (2008) German Federal Health Reporting Institute ICD-10-GM: M15-M19 Osteoarthritis (2008) German Federal Health Reporting Institute
19.
Zurück zum Zitat Konig HH, Bernert S, Angermeyer MC (2005) Health status of the German population: results of a representative survey using the EuroQol questionnaire. Gesundheitswesen 67:173–182PubMedCrossRef Konig HH, Bernert S, Angermeyer MC (2005) Health status of the German population: results of a representative survey using the EuroQol questionnaire. Gesundheitswesen 67:173–182PubMedCrossRef
20.
Zurück zum Zitat Krabbe PF, Essink-Bot ML, Bonsel GJ (1997) The comparability and reliability of five health-state valuation methods. Soc Sci Med 45:1641–1652PubMedCrossRef Krabbe PF, Essink-Bot ML, Bonsel GJ (1997) The comparability and reliability of five health-state valuation methods. Soc Sci Med 45:1641–1652PubMedCrossRef
21.
Zurück zum Zitat Krummenauer F, Wolf C, Gunther KP, Kirschner S (2009) Clinical benefit and cost effectiveness of total knee arthroplasty in the older patient. Eur J Med Res 14:76–84PubMedCrossRef Krummenauer F, Wolf C, Gunther KP, Kirschner S (2009) Clinical benefit and cost effectiveness of total knee arthroplasty in the older patient. Eur J Med Res 14:76–84PubMedCrossRef
22.
Zurück zum Zitat Lavernia C, Lee DJ, Hernandez VH (2006) The increasing financial burden of knee revision surgery in the United States. Clin Orthop Relat Res 446:221–226PubMedCrossRef Lavernia C, Lee DJ, Hernandez VH (2006) The increasing financial burden of knee revision surgery in the United States. Clin Orthop Relat Res 446:221–226PubMedCrossRef
23.
Zurück zum Zitat Le Galès C, Buron C, Costet N, Rosman S, Slama G (2001) Développement d’un index d’états de santé pondéré par les utilités en population française. Économie et Prévision 150–1:71–78 Le Galès C, Buron C, Costet N, Rosman S, Slama G (2001) Développement d’un index d’états de santé pondéré par les utilités en population française. Économie et Prévision 150–1:71–78
24.
Zurück zum Zitat Leigh JP, Fries JF (1994) Arthritis and mortality in the epidemiological follow-up to the national health and nutrition examination survey I. Bull N Y Acad Med 71:69–86PubMed Leigh JP, Fries JF (1994) Arthritis and mortality in the epidemiological follow-up to the national health and nutrition examination survey I. Bull N Y Acad Med 71:69–86PubMed
25.
Zurück zum Zitat London NJ, Miller LE, Block JE (2011) Clinical and economic consequences of the treatment gap in knee osteoarthritis management. Med Hypotheses 76:887–892PubMedCrossRef London NJ, Miller LE, Block JE (2011) Clinical and economic consequences of the treatment gap in knee osteoarthritis management. Med Hypotheses 76:887–892PubMedCrossRef
26.
Zurück zum Zitat Losina E, Walensky RP, Kessler CL, Emrani PS, Reichmann WM, Wright EA, Holt HL, Solomon DH, Yelin E, Paltiel AD, Katz JN (2009) Cost-effectiveness of total knee arthroplasty in the United States: patient risk and hospital volume. Arch Intern Med 169:1113–1121PubMedCrossRef Losina E, Walensky RP, Kessler CL, Emrani PS, Reichmann WM, Wright EA, Holt HL, Solomon DH, Yelin E, Paltiel AD, Katz JN (2009) Cost-effectiveness of total knee arthroplasty in the United States: patient risk and hospital volume. Arch Intern Med 169:1113–1121PubMedCrossRef
27.
Zurück zum Zitat Losina E, Walensky RP, Reichmann WM, Holt HL, Gerlovin H, Solomon DH, Jordan JM, Hunter DJ, Suter LG, Weinstein AM, Paltiel AD, Katz JN (2011) Impact of obesity and knee osteoarthritis on morbidity and mortality in older Americans. Ann Intern Med 154:217–226PubMedCrossRef Losina E, Walensky RP, Reichmann WM, Holt HL, Gerlovin H, Solomon DH, Jordan JM, Hunter DJ, Suter LG, Weinstein AM, Paltiel AD, Katz JN (2011) Impact of obesity and knee osteoarthritis on morbidity and mortality in older Americans. Ann Intern Med 154:217–226PubMedCrossRef
28.
Zurück zum Zitat Loza E, Lopez-Gomez JM, Abasolo L, Maese J, Carmona L, Batlle-Gualda E (2009) Economic burden of knee and hip osteoarthritis in Spain. Arthritis Rheum 61:158–165PubMedCrossRef Loza E, Lopez-Gomez JM, Abasolo L, Maese J, Carmona L, Batlle-Gualda E (2009) Economic burden of knee and hip osteoarthritis in Spain. Arthritis Rheum 61:158–165PubMedCrossRef
29.
Zurück zum Zitat Maetzel A, Li LC, Pencharz J, Tomlinson G, Bombardier C (2004) The economic burden associated with osteoarthritis, rheumatoid arthritis, and hypertension: a comparative study. Ann Rheum Dis 63:395–401PubMedCrossRef Maetzel A, Li LC, Pencharz J, Tomlinson G, Bombardier C (2004) The economic burden associated with osteoarthritis, rheumatoid arthritis, and hypertension: a comparative study. Ann Rheum Dis 63:395–401PubMedCrossRef
31.
Zurück zum Zitat Nichol G, Llewellyn-Thomas HA, Thiel EC, Naylor CD (1996) The relationship between cardiac functional capacity and patients’ symptom-specific utilities for angina: some findings and methodologic lessons. Med Decis Making 16:78–85PubMedCrossRef Nichol G, Llewellyn-Thomas HA, Thiel EC, Naylor CD (1996) The relationship between cardiac functional capacity and patients’ symptom-specific utilities for angina: some findings and methodologic lessons. Med Decis Making 16:78–85PubMedCrossRef
32.
Zurück zum Zitat Nichol MB, Sengupta N, Globe DR (2001) Evaluating quality-adjusted life years: estimation of the health utility index (HUI2) from the SF-36. Med Decis Making 21:105–112PubMed Nichol MB, Sengupta N, Globe DR (2001) Evaluating quality-adjusted life years: estimation of the health utility index (HUI2) from the SF-36. Med Decis Making 21:105–112PubMed
33.
Zurück zum Zitat Parmet S, Lynm C, Glass RM (2003) JAMA patient page. Osteoarthritis of the knee. JAMA 289:1068PubMedCrossRef Parmet S, Lynm C, Glass RM (2003) JAMA patient page. Osteoarthritis of the knee. JAMA 289:1068PubMedCrossRef
35.
Zurück zum Zitat Rabenda V, Manette C, Lemmens R, Mariani AM, Struvay N, Reginster JY (2006) Direct and indirect costs attributable to osteoarthritis in active subjects. J Rheumatol 33:1152–1158PubMed Rabenda V, Manette C, Lemmens R, Mariani AM, Struvay N, Reginster JY (2006) Direct and indirect costs attributable to osteoarthritis in active subjects. J Rheumatol 33:1152–1158PubMed
36.
Zurück zum Zitat Rachlis M, Kushner C (1989) Second opinion: what’s wrong in Canada’s health care system and how to fix it. Collins, Toronto Rachlis M, Kushner C (1989) Second opinion: what’s wrong in Canada’s health care system and how to fix it. Collins, Toronto
37.
Zurück zum Zitat Rand JA, Trousdale RT, Ilstrup DM, Harmsen WS (2003) Factors affecting the durability of primary total knee prostheses. J Bone Joint Surg Am 85-A:259–265PubMed Rand JA, Trousdale RT, Ilstrup DM, Harmsen WS (2003) Factors affecting the durability of primary total knee prostheses. J Bone Joint Surg Am 85-A:259–265PubMed
38.
Zurück zum Zitat Szende A, Oppe M, Devlin N (2007) EQ-5D value sets: inventory, comparative review and user guide, vol 2. EuroQol Group Monographs Szende A, Oppe M, Devlin N (2007) EQ-5D value sets: inventory, comparative review and user guide, vol 2. EuroQol Group Monographs
39.
Zurück zum Zitat Tengs TO, Adams ME, Pliskin JS, Safran DG, Siegel JE, Weinstein MC, Graham JD (1995) Five-hundred life-saving interventions and their cost-effectiveness. Risk Anal 15:369–390 Tengs TO, Adams ME, Pliskin JS, Safran DG, Siegel JE, Weinstein MC, Graham JD (1995) Five-hundred life-saving interventions and their cost-effectiveness. Risk Anal 15:369–390
40.
Zurück zum Zitat Torrance GW, Feeny D, Furlong W (2001) Visual analog scales: do they have a role in the measurement of preferences for health states? Med Decis Making 21:329–334PubMed Torrance GW, Feeny D, Furlong W (2001) Visual analog scales: do they have a role in the measurement of preferences for health states? Med Decis Making 21:329–334PubMed
41.
Zurück zum Zitat Torrance GW, Feeny DH, Furlong WJ, Barr RD, Zhang Y, Wang Q (1996) Multiattribute utility function for a comprehensive health status classification system. Health utilities index mark 2. Med Care 34:702–722PubMedCrossRef Torrance GW, Feeny DH, Furlong WJ, Barr RD, Zhang Y, Wang Q (1996) Multiattribute utility function for a comprehensive health status classification system. Health utilities index mark 2. Med Care 34:702–722PubMedCrossRef
42.
Zurück zum Zitat Wolfson AD, Bombardier C, McGeer A (1982) Preference measurements for functional status in stroke patients: interrater and intertechnique comparisons. In: Kane RL (ed) Values in long term care. DC Heath & Co, Toronto, pp 191–214 Wolfson AD, Bombardier C, McGeer A (1982) Preference measurements for functional status in stroke patients: interrater and intertechnique comparisons. In: Kane RL (ed) Values in long term care. DC Heath & Co, Toronto, pp 191–214
43.
Zurück zum Zitat Woolf AD, Pfleger B (2003) Burden of major musculoskeletal conditions. Bull World Health Organ 81:646–656PubMed Woolf AD, Pfleger B (2003) Burden of major musculoskeletal conditions. Bull World Health Organ 81:646–656PubMed
Metadaten
Titel
Cost-effectiveness and economic impact of the KineSpring® Knee Implant System in the treatment for knee osteoarthritis
verfasst von
Chuan Silvia Li
Thomas Seeger
Thomas C. Auhuber
Mohit Bhandari
Publikationsdatum
01.11.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 11/2013
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2427-x

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