Cost-effectiveness of balloon kyphoplasty in patients with symptomatic vertebral compression fractures in a UK setting.
CONCLUSIONS
Balloon kyphoplasty (BKP) is a procedure used to treat vertebral compression fractures (VCFs). We developed a cost-effectiveness model to evaluate BKP in United Kingsdom patients with hospitalised VCFs and estimated the cost-effectiveness of BKP compared to non-surgical management. The results indicate that BKP provides a cost-effective alternative for treating these patients.


BACKGROUND
VCFs of osteoporotic patients are associated with chronic pain, a reduction in health-related quality of life (QoL) and high healthcare costs. BKP is a minimally invasive procedure that has resulted in pain relief, vertebral body height-restoration, decreased kyphosis and improved physical functioning in patients with symptomatic VCFs. BKP was shown to improve health-related QoL in a 12-month interim analysis of a randomised phase-III trial.


METHODS
The objectives of this study were to develop a Markov cost-effectiveness model to evaluate BKP in patients with painful hospitalised VCFs and to estimate the cost-effectiveness of BKP compared with non-surgical management in a UK setting. It was assumed that QoL-benefits found at 12 months linearly approached zero during another 2 years, and that patients receiving BKP warranted six fewer hospital bed days compared with patients given non-surgical management.


RESULTS
The procedure was associated with quality-adjusted life-years (QALY)-gains of 0.17 and cost/QALY-gains at 8,800 pound sterling. The results were sensitive to assumptions about avoided length of hospital-stay and persistence of kyphoplasty-related QoL-benefits.


CONCLUSIONS
In conclusion, the results indicate that BKP provides a cost-effective alternative for treating patients with hospitalised VCFs in a UK-setting.
Ström
O
O
i3 Innovus, Stockholm, Sweden. oskar.strom@i3innovus.com
Leonard
C
C
Marsh
D
D
Cooper
C
C
D000368:Aged; D002404:Catheterization / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D050815:Fractures, Compression / Q000191:economics / Q000401:mortality / Q000601:surgery*; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D058498:Kyphoplasty / Q000191:economics* / Q000379:methods; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D017059:Models, Econometric; D058866:Osteoporotic Fractures / Q000191:economics / Q000401:mortality / Q000601:surgery*; D011788:Quality of Life; D016103:Spinal Fractures / Q000191:economics / Q000401:mortality / Q000601:surgery*; D006113:United Kingdom / Q000453:epidemiology