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Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: Cost-utility analysis of arthroscopic rotator cuff repair : a prospective health economic study using real-world data
Authors: Grobet, Cécile
Audigé, Laurent
Eichler, Klaus
Meier, Flurina
Brunner, Beatrice
Wieser, Simon
Flury, Matthias
et. al: No
DOI: 10.1016/j.asmr.2020.02.001
Published in: Arthroscopy, Sports Medicine, and Rehabilitation
Volume(Issue): 2
Issue: 3
Page(s): 193
Pages to: 205
Issue Date: 25-Apr-2020
Publisher / Ed. Institution: Elsevier
ISSN: 2666-061X
Language: English
Subject (DDC): 362.1041: Health economics
Abstract: Purpose: To assess the change in quality of life (QOL) and costs for patients with rotator cuff tears after arthroscopic rotator cuff repair (aRCR) compared with continued nonoperativemanagement, using real-world evidence. Methods: Patients indicated for aRCR were included in a prospective study and followed up to 2 years after surgery (postop) for allmeasurements. QOL (EQ-5D-5L) and shoulder function (Constant Score, Oxford Shoulder Score, subjective shoulder value) were assessed. Sixteen major insurance companies provided all-diagnoses direct medical costs in Swiss francs (CHF; 1 CHF ¼ 1.03 USD). Baseline data at recruitment and costs sustained over 1 year before surgery (preop) served as a proxy for nonoperative management. Total direct medical costs to gain 1 extra quality-adjusted life year (QALY) were calculated as the incremental costeffectiveness ratio (ICER; mean of 2 years postop compared with 1 year preop) from a societal perspective. Subgroup analyses were separately performed for traumatic (trauma-OP) and degenerative (degen-OP) rotator cuff tear patients. Sensitivity analyses for aRCR patients includedmore intensive nonoperative treatment with corresponding QOL gain. The relationship between QOL and shoulder function was explored using regression analysis. Results: For 153 aRCR patients (mean age 57 years; 63% male), themean EQ-5D index improved from 0.71 (preop) to 0.94 (1 year postop) and 0.96 (2 years postop). Mean total costs increased from 5,499 CHF (preop) to 17,116 CHF (1 year postop), then decreased to 4,226CHF (2 years postop). The ICER for all aRCR patients was 24,924 CHF/QALY (95%confidence interval [CI] 16,742 to 33,106) and 17,357 CHF/QALY (95% CI 10,951 to 23,763) and 36,474 CHF/QALY (95% CI 16,301 to 56,648) for the trauma-OP and degen-OP groups, respectively. QOL and shoulder function were significantly associated (P < .001). Conclusions: For RC patients treated at a specialized Swiss orthopaedic clinic, aRCR is a cost-effective intervention associated with clinically relevant improvement in QOL up to 2 years after repair compared with prior nonoperative management. Level of Evidence: Economic Analyses e Developing an Economic Model, Level II
Fulltext version: Published version
License (according to publishing contract): CC BY-NC-ND 4.0: Attribution - Non commercial - No derivatives 4.0 International
Departement: School of Management and Law
Organisational Unit: Winterthur Institute of Health Economics (WIG)
Appears in collections:Publikationen School of Management and Law

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