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Knee Joint01:23

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Updated: Feb 13, 2026

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Value-based procurement of prostheses for total knee replacement.

Andrea Messori1, Sabrina Trippoli1

  • 1HTA Section, ESTAR Toscana, Regional Health Service, Firenze, Italy.

Orthopedic Reviews
|March 23, 2018
PubMed
Summary

Pharmacoeconomic models can improve value for money in total knee arthroplasty (TKA) device procurement. Incorporating cost-effectiveness into tenders maximizes value, optimizing TKA device selection for better healthcare spending.

Keywords:
Markov modelingcost-effectivenessknee arthroplastynet monetary benefitprocurementtenders

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Area of Science:

  • Health Economics
  • Medical Device Procurement
  • Orthopedic Surgery

Background:

  • Cost-effectiveness evaluations for total knee arthroplasty (TKA) devices have limited real-world impact.
  • Current procurement practices may not fully optimize the value for money of TKA devices.

Purpose of the Study:

  • To explore the application of pharmacoeconomic models in TKA device procurement.
  • To enhance the value for money achieved through TKA device purchasing.

Main Methods:

  • A three-phase approach: literature review for TKA data, Markov model development for cost-effectiveness analysis, and simulated tenders for value-based procurement.
  • Data from a single 2016 study was used to evaluate five TKA devices.
  • Net Monetary Benefit (NMB) and tender scores were calculated to rank devices.

Main Results:

  • The study successfully simulated tenders incorporating cost-effectiveness principles for TKA devices.
  • Calculated Quality-Adjusted Life Years (QALYs) ranged from 7.1919 to 7.4952.
  • Net Monetary Benefit (NMB) varied from £138,040 to £144,184, with tender scores from 0 to 100.

Conclusions:

  • Integrating cost-effectiveness into the tendering process for TKA devices is feasible.
  • This approach can significantly maximize the value for money in TKA device procurement.
  • Optimized procurement strategies can lead to improved resource allocation in orthopedic surgery.