Open AccessCOST-UTILITY ANALYSIS OF ARTHROSCOPIC MATRIX-BASED MENISCUS REPAIR (AMMR) IN THE PERSPECTIVE OF POLISH NATIONAL HEALTH SERVICE AND PRIVATE PATIENTS – 10-YEAR HORIZON
Author(s) -
Kinga Ciemniewska-Gorzela,
Tomasz Piontek,
Jakub Naczk,
Paweł Bąkowski,
Justus Gille,
Teresa Łuczka
Publication year - 2021
Publication title -
issue of rehabilitation, orthopaedy, neurophysiology and sport promotion-irons
Language(s) - English
Resource type - Journals
ISSN - 2300-0767
DOI - 10.19271/irons-000134-2021-35
Subject(s) - meniscus , cost–utility analysis , medicine , perspective (graphical) , cost–benefit analysis , cost effectiveness , surgery , physical therapy , computer science , risk analysis (engineering) , artificial intelligence , mathematics , incidence (geometry) , ecology , geometry , biology
Clinical data has indicated that Arthroscopic Matrix-based Meniscus Repair (AMMR) offers a means to preserve the meniscus in patients who would otherwise be scheduled for meniscectomy, although AMMR has significant upfront costs. Aim The objective of this study was to estimate the cost-effectiveness of AMMR in Poland in both the National Health Service (PNHS) and from the perspective of private patients (PP). Material and methods A Markov health-state model was developed to evaluate the cost-utility analysis of AMMR compared to meniscectomy (ME) for patients with a complex meniscus tear, using a 10-years horizon, modelling a cohort of 1000 patients. Initial probabilities and clinical course were simulated based on previously published data. A literature review identified different clinical outcome probabilities and health-related utility scores associated with each health state. Cost-effectiveness was presented as an indicator of Incremental Cost-Utility Ratio (ICUR). Costs were taken from published sources for the perspective of PNHS and from a private clinic offers for the perspective of PP. Results In the 10-year horizon, AMMR was associated with an increase in discounted qualityadjusted life-years (QALYs) to 7 778.25 compared to 7 454.33 for ME. In both perspectives, (PNHS and PP) the ICUR cost is smaller than willingness to pay (WTP) parameter (PNHSICUR = 34.212.92 versus PP-ICUR = 29.897.36). Conclusions: Despite the increase in costs, the procedure is cost-effective at standard thresholds used in Poland for analyzed perspectives. Keywords: knee; meniscus; collagen matrix; cost-effectiveness; economic analysis; Markov model