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Health economic aspects of vertebral augmentation procedures
F Borgström1, D P Beall, S Berven
1Quantify Research, Stockholm, Sweden, fredrik.borgstrom@quantifyresearch.com.
Summary
Vertebral augmentation procedures like vertebroplasty and balloon kyphoplasty are generally cost-effective for osteoporotic fractures, but results depend heavily on specific data inputs. More research on long-term outcomes is needed for certainty.
Area of Science:
- Orthopedics
- Health Economics
- Evidence Synthesis
Background:
- Osteoporotic vertebral compression fractures cause pain and instability.
- Vertebral augmentation procedures (VAPs), including vertebroplasty (VP) and balloon kyphoplasty (BKP), aim to stabilize fractures and alleviate pain.
- Economic evaluations are crucial for understanding the value of VAPs.
Purpose of the Study:
- To systematically review the cost-effectiveness of VAPs for osteoporotic vertebral compression fractures.
- To identify challenges in the economic evaluation of VAPs.
Main Methods:
- Systematic literature search for full economic evaluations of VAPs in osteoporosis patients.
- Inclusion criteria focused on studies measuring morbidity and mortality using quality-adjusted life years (QALYs).
- Analysis of identified studies regarding design, modeling, data, and results.
Main Results:
- Only five relevant studies were identified from 949 initial searches.
- Three out of five studies found VAPs to be cost-effective compared to non-surgical management (NSM) in base case analyses.
- Significant variations in results were driven by factors like time horizon, quality of life effects, treatment offset, reduced bed days, and mortality benefits.
Conclusions:
- The cost-effectiveness of VAPs remains uncertain due to wide variations in study methodologies and data.
- Further cost-effectiveness analyses may offer limited benefit; research should focus on improving underlying data, particularly long-term clinical outcomes.
- High-quality data is essential for definitive conclusions on VAP cost-effectiveness.
