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Health economic aspects of vertebral augmentation procedures

Borgstrom, F.; Beall, D. P.; Berven, S.; Boonen, S.; Christie, S.; Kallmes, D. F.; Kanis, J. A.; Olafsson, G.; Singer, A. J. and Åkesson, Kristina LU (2015) In Osteoporosis International 26(4). p.1239-1249
Abstract
We reviewed all peer-reviewed papers analysing the cost-effectiveness of vertebroplasty and balloon kyphoplasty for osteoporotic vertebral compression fractures. In general, the procedures appear to be cost effective but are very dependent upon model input details. Better data, rather than new models, are needed to answer outstanding questions. Vertebral augmentation procedures (VAPs), including vertebroplasty (VP) and balloon kyphoplasty (BKP), seek to stabilise fractured vertebral bodies and reduce pain. The aim of this paper is to review current literature on the cost-effectiveness of VAPs as well as to discuss the challenges for economic evaluation in this research area. A systematic literature search was conducted to identify existing... (More)
We reviewed all peer-reviewed papers analysing the cost-effectiveness of vertebroplasty and balloon kyphoplasty for osteoporotic vertebral compression fractures. In general, the procedures appear to be cost effective but are very dependent upon model input details. Better data, rather than new models, are needed to answer outstanding questions. Vertebral augmentation procedures (VAPs), including vertebroplasty (VP) and balloon kyphoplasty (BKP), seek to stabilise fractured vertebral bodies and reduce pain. The aim of this paper is to review current literature on the cost-effectiveness of VAPs as well as to discuss the challenges for economic evaluation in this research area. A systematic literature search was conducted to identify existing published studies on the cost-effectiveness of VAPs in patients with osteoporosis. Only peer-reviewed published articles that fulfilled the criteria of being regarded as full economic evaluations including both morbidity and mortality in the outcome measure in the form of quality-adjusted life years (QALYs) were included. The search identified 949 studies, of which four (0.4 %) were identified as relevant with one study added later. The reviewed studies differed widely in terms of study design, modelling framework and data used, yielding different results and conclusions regarding the cost-effectiveness of VAPs. Three out of five studies indicated in the base case results that VAPs were cost effective compared to non-surgical management (NSM). The five main factors that drove the variations in the cost-effectiveness between the studies were time horizon, quality of life effect of treatment, offset time of the treatment effect, reduced number of bed days associated with VAPs and mortality benefit with treatment. The cost-effectiveness of VAPs is uncertain. In answering the remaining questions, new cost-effectiveness analysis will yield limited benefit. Rather, studies that can reduce the uncertainty in the underlying data, especially regarding the long-term clinical outcomes of VAPs, should be conducted. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Balloon kyphoplasty, Cost-effectiveness, Fracture, Osteoporosis, Quality, of life, Vertebroplasty
in
Osteoporosis International
volume
26
issue
4
pages
1239 - 1249
publisher
Springer
external identifiers
  • wos:000351210500002
  • scopus:84928344238
ISSN
1433-2965
DOI
10.1007/s00198-014-2953-5
language
English
LU publication?
yes
id
087ff1a8-4969-4a46-968d-ab4a63b1b179 (old id 5281971)
date added to LUP
2015-05-04 08:51:49
date last changed
2017-01-01 05:58:09
@article{087ff1a8-4969-4a46-968d-ab4a63b1b179,
  abstract     = {We reviewed all peer-reviewed papers analysing the cost-effectiveness of vertebroplasty and balloon kyphoplasty for osteoporotic vertebral compression fractures. In general, the procedures appear to be cost effective but are very dependent upon model input details. Better data, rather than new models, are needed to answer outstanding questions. Vertebral augmentation procedures (VAPs), including vertebroplasty (VP) and balloon kyphoplasty (BKP), seek to stabilise fractured vertebral bodies and reduce pain. The aim of this paper is to review current literature on the cost-effectiveness of VAPs as well as to discuss the challenges for economic evaluation in this research area. A systematic literature search was conducted to identify existing published studies on the cost-effectiveness of VAPs in patients with osteoporosis. Only peer-reviewed published articles that fulfilled the criteria of being regarded as full economic evaluations including both morbidity and mortality in the outcome measure in the form of quality-adjusted life years (QALYs) were included. The search identified 949 studies, of which four (0.4 %) were identified as relevant with one study added later. The reviewed studies differed widely in terms of study design, modelling framework and data used, yielding different results and conclusions regarding the cost-effectiveness of VAPs. Three out of five studies indicated in the base case results that VAPs were cost effective compared to non-surgical management (NSM). The five main factors that drove the variations in the cost-effectiveness between the studies were time horizon, quality of life effect of treatment, offset time of the treatment effect, reduced number of bed days associated with VAPs and mortality benefit with treatment. The cost-effectiveness of VAPs is uncertain. In answering the remaining questions, new cost-effectiveness analysis will yield limited benefit. Rather, studies that can reduce the uncertainty in the underlying data, especially regarding the long-term clinical outcomes of VAPs, should be conducted.},
  author       = {Borgstrom, F. and Beall, D. P. and Berven, S. and Boonen, S. and Christie, S. and Kallmes, D. F. and Kanis, J. A. and Olafsson, G. and Singer, A. J. and Åkesson, Kristina},
  issn         = {1433-2965},
  keyword      = {Balloon kyphoplasty,Cost-effectiveness,Fracture,Osteoporosis,Quality,of life,Vertebroplasty},
  language     = {eng},
  number       = {4},
  pages        = {1239--1249},
  publisher    = {Springer},
  series       = {Osteoporosis International},
  title        = {Health economic aspects of vertebral augmentation procedures},
  url          = {http://dx.doi.org/10.1007/s00198-014-2953-5},
  volume       = {26},
  year         = {2015},
}