Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-22264
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dc.contributor.authorGrobet, Cécile-
dc.contributor.authorGlanzmann, Michael C.-
dc.contributor.authorEichler, Klaus-
dc.contributor.authorRickenbacher, Dominik-
dc.contributor.authorMeier, Flurina-
dc.contributor.authorBrunner, Beatrice-
dc.contributor.authorAudigé, Laurent-
dc.date.accessioned2021-04-15T13:54:27Z-
dc.date.available2021-04-15T13:54:27Z-
dc.date.issued2021-
dc.identifier.issn1058-2746de_CH
dc.identifier.issn1532-6500de_CH
dc.identifier.urihttps://digitalcollection.zhaw.ch/handle/11475/22264-
dc.description.abstractBackground: With increasing health care expenditures, knowledge about the benefit and costs of surgical interventions such as total shoulder arthroplasty (TSA) becomes important for orthopedic surgeons, social insurances and health policy decision makers. We examined the impact of TSA on quality of life (QOL), direct medical costs and productivity losses, and evaluated the cost-utility ratio of TSA compared to ongoing nonoperative management using real-world data. Methods: Patients with shoulder osteoarthritis and/or rotator cuff tear arthropathy indicated for anatomical or reverse TSA were included in this prospective study. Quality of life (EQ-5D-5L) and shoulder function (Constant Score, Shoulder Pain and Disability Index, short version of the Disabilities of the Arm, Shoulder and Hand questionnaire, Subjective Shoulder Value) were assessed before (preop) and up to 2 years after surgery (postop). Health insurance companies provided all-diagnoses direct medical costs for 2018 in Swiss francs (CHF), where 1 CHF was equivalent to 1.02 USD. Indirect costs were assessed using the work productivity and activity impairment questionnaire. Baseline data at recruitment and the total costs of the preop year served as a proxy for nonoperative management. The incremental cost-effectiveness ratio (ICER) was calculated as the total costs to gain one extra quality-adjusted life year (QALY) based on both the health care system and societal perspective. The relationship between QOL and shoulder function was assessed by regression analysis. Results: The mean preOP EQ-5D-5L utility index of 0.68 for a total of 150 patients (mean age 71 years; 21% working; 58% female) increased to 0.89 and 0.87 at 1 and 2 years postop, respectively. Mean direct medical costs were 11,771 CHF (preop), 34,176 CHF (1 year postop) and 11,763 CHF (2 years postop). The ICER was 63,299 CHF/QALY (95% confidence interval [CI]: 44,391; 82,206). Mean productivity losses for 30 working patients decreased from 40,574 CHF per patient (preop) to 26,114 CHF at 1 year postop and 10,310 CHF at 2 years postop. When considering these productivity losses, the ICER was 35,549 CHF/QALY (95% CI: 12,076; 59,016). Quality of life was significantly associated with shoulder function (p < 0.001). Conclusion: Using real-world direct medical cost data, we calculated a cost-utility ratio of 63,299 CHF/QALY for TSA in Switzerland, which clearly falls below the often suggested 100,000 CHF/QALY threshold for acceptable cost-effectiveness. In view of productivity losses, TSA becomes highly cost-effective with an ICER of 35,546 CHF/QALY.de_CH
dc.language.isoende_CH
dc.publisherElsevierde_CH
dc.relation.ispartofJournal of Shoulder and Elbow Surgeryde_CH
dc.rightshttp://creativecommons.org/licenses/by-nc-nd/4.0/de_CH
dc.subjectEuropean Quality of Life EQ-5Dde_CH
dc.subjectCost-effectivenessde_CH
dc.subjectCost-utilityde_CH
dc.subjectIncremental cost-effectiveness ratiode_CH
dc.subjectQuality of lifede_CH
dc.subjectReal-world datade_CH
dc.subjectTotal shoulder arthroplastyde_CH
dc.subject.ddc362.1041: Gesundheitsökonomiede_CH
dc.titleCost-utility analysis of total shoulder arthroplasty : a prospective health economic study using real-world datade_CH
dc.typeBeitrag in wissenschaftlicher Zeitschriftde_CH
dcterms.typeTextde_CH
zhaw.departementSchool of Management and Lawde_CH
zhaw.organisationalunitWinterthurer Institut für Gesundheitsökonomie (WIG)de_CH
dc.identifier.doi10.1016/j.jse.2021.03.136de_CH
dc.identifier.doi10.21256/zhaw-22264-
dc.identifier.pmid33774171de_CH
zhaw.funding.euNode_CH
zhaw.issue9de_CH
zhaw.originated.zhawYesde_CH
zhaw.pages.end2006de_CH
zhaw.pages.start1998de_CH
zhaw.publication.statuspublishedVersionde_CH
zhaw.volume30de_CH
zhaw.publication.reviewPeer review (Publikation)de_CH
zhaw.author.additionalNode_CH
zhaw.display.portraitYesde_CH
Appears in collections:Publikationen School of Management and Law

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Grobet, C., Glanzmann, M. C., Eichler, K., Rickenbacher, D., Meier, F., Brunner, B., & Audigé, L. (2021). Cost-utility analysis of total shoulder arthroplasty : a prospective health economic study using real-world data. Journal of Shoulder and Elbow Surgery, 30(9), 1998–2006. https://doi.org/10.1016/j.jse.2021.03.136
Grobet, C. et al. (2021) ‘Cost-utility analysis of total shoulder arthroplasty : a prospective health economic study using real-world data’, Journal of Shoulder and Elbow Surgery, 30(9), pp. 1998–2006. Available at: https://doi.org/10.1016/j.jse.2021.03.136.
C. Grobet et al., “Cost-utility analysis of total shoulder arthroplasty : a prospective health economic study using real-world data,” Journal of Shoulder and Elbow Surgery, vol. 30, no. 9, pp. 1998–2006, 2021, doi: 10.1016/j.jse.2021.03.136.
GROBET, Cécile, Michael C. GLANZMANN, Klaus EICHLER, Dominik RICKENBACHER, Flurina MEIER, Beatrice BRUNNER und Laurent AUDIGÉ, 2021. Cost-utility analysis of total shoulder arthroplasty : a prospective health economic study using real-world data. Journal of Shoulder and Elbow Surgery. 2021. Bd. 30, Nr. 9, S. 1998–2006. DOI 10.1016/j.jse.2021.03.136
Grobet, Cécile, Michael C. Glanzmann, Klaus Eichler, Dominik Rickenbacher, Flurina Meier, Beatrice Brunner, and Laurent Audigé. 2021. “Cost-Utility Analysis of Total Shoulder Arthroplasty : A Prospective Health Economic Study Using Real-World Data.” Journal of Shoulder and Elbow Surgery 30 (9): 1998–2006. https://doi.org/10.1016/j.jse.2021.03.136.
Grobet, Cécile, et al. “Cost-Utility Analysis of Total Shoulder Arthroplasty : A Prospective Health Economic Study Using Real-World Data.” Journal of Shoulder and Elbow Surgery, vol. 30, no. 9, 2021, pp. 1998–2006, https://doi.org/10.1016/j.jse.2021.03.136.


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