title: Health economics: a cost analysis of treatment of persistent fracture non-unions using bone morphogenetic protein-7.
abstract: OBJECTIVE
  To compare the cost implications of treatment of persistent fracture non-unions before and after application of recombinant human bone morphogenetic protein-7 (BMP-7).
  
  
  METHODS
  Of 25 fracture non-unions, 9 were treated using BMP-7 alone and 16 using BMP-7 and bone grafting. These patients were prospectively followed up, and the costs incurred were analysed.
  
  
  RESULTS
  The mean number of procedures per fracture performed before application of BMP-7 was 4.16, versus 1.2 thereafter. Mean hospital stay and cost of treatment per fracture before receiving BMP-7 were 26.84 days and pound 13,844.68, versus 7.8 days and pound 7338.4 thereafter. The overall cost of treatment of persistent fracture non-unions with BMP-7 was 47.0% less than that of the numerous previous unsuccessful treatments (p=0.001).
  
  
  CONCLUSIONS
  Treating fracture non-unions is costly, but this could be reduced by early BMP-7 administration when a complex or persistent fracture non-union is present or anticipated.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, St. James's University Hospital, Leeds LS9 7TF, UK.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Dahabreh
authors.forename: Rozalia
authors.initials: R
authors.lastname: Dimitriou
authors.forename: Peter V
authors.initials: PV
authors.lastname: Giannoudis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins / Q000191:economics* / Q000627:therapeutic use*; D001861:Bone Regeneration; D016025:Bone Transplantation / Q000191:economics*; D003365:Costs and Cost Analysis; D016527:Drug Costs; D005260:Female; D017102:Fracture Healing; D050723:Fractures, Bone / Q000188:drug therapy* / Q000601:surgery; D005599:Fractures, Ununited / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000191:economics / Q000627:therapeutic use; D012086:Reoperation / Q000191:economics; D016212:Transforming Growth Factor beta / Q000191:economics* / Q000627:therapeutic use*; D006113:United Kingdom
chemical_list: C525819:BMP7 protein, human; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta