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膝关节动脉栓塞,射频切除和膝关节骨关节炎的皮质类固醇治疗:使用随机临床试验数据进行成本效益分析

Daniel H Kwak¹, Hayden L Hofmann², Mikin Patel¹

¹Department of Radiology, Section of Interventional Radiology, The University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL 60637.

AJR. American journal of roentgenology

|September 25, 2024

概括

与射频切除 (RFA) 和皮质类固醇 (CS) 注射相比,生殖动脉栓塞 (GAE) 是症状膝关节关节炎 (KOA) 的最具成本效益的治疗方法. 尽管成功率和使用率各不相同,但GAE提供了更好的价值.

科学领域:

干预心脏病学干预心脏病学
整形外科手术整形外科手术
卫生经济学卫生经济学

背景情况:

膝关节骨关节炎 (KOA) 患者经常有耐火症状,尽管传统的治疗方法,出现的微创性选择,如生殖关节动脉栓塞 (GAE) 和射频切除 (RFA).
这些程序为无法接受或拒绝接受手术的患者提供了替代方案.

研究的目的:

进行成本效益分析 (CEA),比较GAE,RFA和对症状KOA的皮质类固醇 (CS) 治疗.
利用基于随机对照试验的 de novo 网络元分析 (NMA) 的马尔科夫模型.

主要方法:

马尔科夫队列状态过渡模型从美国医疗保险支付人的角度在4年的时间范围内被采用.
该模型结合了来自RCT的NMA的治疗成功率/磨损率,成本和实用收益.
在每获得的质量调整寿命年 (QALY) 支付10万美元的愿意支付门下进行了分析,包括对成本设置的敏感性分析.

主要成果:

与GAE相比,射频除 (RFA) 显示出较大的短期治疗效果.
与CS相比,每QALY获得的增量成本效益比率为GAE的5611563美元和RFA的76429美元.
与RFA (18.429.2%) 相比,GAE具有更高的成本效益概率 (41.654.8%).

结论:

阴茎动脉栓塞 (GAE) 在各种场景中始终成为症状KOA最可能的经济有效的治疗选择.
GAE的成本效益受临床成功率,消耗率和实用价值的影响.
GAE提供了一个可能更具成本效益的RFA和CS替代方案,用于管理症状KOA.

关键词:

经济效益性经济效益性阴茎动脉栓塞的发生医疗保健经济学经济学干预性放射学是干预性的放射学.膝盖骨关节炎膝盖骨关节炎

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