Cost-effectiveness of the reverse total shoulder arthroplasty. Does indication affect outcome?

Area of Science:

• Orthopedic Surgery
• Health Economics
• Rehabilitative Medicine

Background:

• Assessing the economic viability of reverse total shoulder arthroplasty (RTSA) is crucial for healthcare resource allocation.
• Understanding the long-term cost-effectiveness of RTSA informs clinical decision-making and patient management.

Purpose of the Study:

• To evaluate the cost-effectiveness of reverse total shoulder arthroplasty (RTSA) over a two-year post-operative period.
• To determine the incremental cost-effectiveness ratio (ICER) per quality-adjusted life year (QALY) gained from RTSA.

Main Methods:

• A prospective cohort of 67 patients undergoing RTSA were monitored for 24 months.
• Patient outcomes were assessed using the Oxford Shoulder Score, Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, and EuroQol 5-dimensional (EQ-5D) questionnaire.
• Complications, healthcare resource utilization, and ICER were recorded to quantify cost-effectiveness.

Main Results:

• The ICER for RTSA was £16,827.43/QALY at one year, decreasing to £8313.48/QALY at two years.
• Primary RTSA demonstrated a lower ICER (£7596.76/QALY) compared to revision RTSA (£11,748.51/QALY) at two years.
• The projected cost per QALY over the estimated 6.9-year life expectancy was £2438.78.

Conclusions:

• Reverse total shoulder arthroplasty is a cost-effective surgical intervention.
• RTSA yields excellent patient outcomes and significant improvements in quality-adjusted life years within two years post-surgery.