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Cost Analyses of Prosthetic Devices: A Systematic Review
Claire A Donnelley1, Corin Shirley2, Ericka P von Kaeppler1
1Department of Orthopaedic Surgery, Institute for Global Orthopaedics and Traumatology, University of California, San Francisco, San Francisco, CA.
Archives of Physical Medicine and Rehabilitation
|March 12, 2021
Summary
Cost-effectiveness of prosthetic devices is under-researched, especially for low-income countries. Advanced prosthetics like microprocessor knees are cost-effective in high-income settings, but more data is needed for LMICs.
Area of Science:
- Rehabilitation Medicine
- Health Economics
- Prosthetics and Orthotics
Background:
- The cost-effectiveness of prosthetic interventions is not well-established, particularly in low- and middle-income countries (LMICs).
- Limited economic analyses exist for prosthetic devices, hindering informed decision-making in resource-constrained settings.
Purpose of the Study:
- To synthesize existing literature on the cost-effectiveness of prosthetic interventions.
- To explore the applicability of these findings to LMIC settings.
Main Methods:
- A systematic literature review was conducted using PubMed, Embase, and Web of Science.
- Included studies performed economic analyses of upper or lower extremity prosthetic devices.
- Twelve studies met inclusion criteria, all focusing on lower extremity amputations in high-income settings.
Main Results:
- Microprocessor-controlled knees demonstrated cost-effectiveness over non-microprocessor knees for transfemoral amputations in high-income settings.
- Findings on osseointegrated versus socket-suspended prostheses were equivocal.
- Advanced prosthetic systems (ICEX, modular sockets) showed increased costs without functional improvement over basic systems.
Conclusions:
- There is a significant gap in the literature regarding the cost-effectiveness of prosthetic interventions, especially for LMICs.
- Further research is needed to assess direct/indirect costs, rehabilitation expenses, and long-term benefits.
- Such studies are crucial for guiding prosthetic and rehabilitative care in resource-austere settings.
