|Publication type:||Conference other|
|Type of review:||No review|
|Title:||Cost-utility analysis of arthroscopic rotator cuff repair : real-world data of reintegration|
|Conference details:||EUMASS Congress & SIM Annual Meeting, online, 16-17 September 2021|
|Subject (DDC):||362.1041: Health economics|
|Abstract:||To examine the influence of arthroscopic rotator cuff repair (aRCR) on quality of life (QOL), direct medical costs and productivity losses, and evaluate the cost-utility ratio of aRCR compared to an alternative scenario of ongoing nonoperative (nonOP) management from a societal perspective in Switzerland. Methods: Patients indicated for aRCR were included in a prospective study and followed up to two years after surgery (postOP) for all measurements. QOL (EQ-5D-5L) and shoulder function (Constant Score, Oxford Shoulder Score, Subjective Shoulder Value) were assessed. Sixteen major insurance companies provided all-diagnoses direct medical costs and patients reported their loss of productivity using the Work Productivity and Activity Impairment Questionnaire. Baseline data at recruitment and costs sustained over one year before (preOP) surgery served as a proxy for nonOP management. Total direct medical costs to gain one extra quality-adjusted life year (QALY) were calculated as the incremental cost-effectiveness ratio (ICER; mean of 2 years postOP compared to 1 year preOP control period). Subgroup analyses were separately performed for traumatic (Trauma-OP) and degenerative (Degen-OP) rotator cuff tear patients. Sensitivity analyses for aRCR patients included intensive nonOP treatment with corresponding QOL gain. The relationship between QOL and shoulder function was explored using regression analysis. Results: For 153 aRCR patients (mean age 57 years; 63% male), the mean EQ-5D index improved from 0.71 (preOP) to 0.94 (1 year postOP) and 0.96 (2 years postOP). Mean total costs increased from 5,499 Swiss Francs (CHF) (preOP) to 17,116 CHF (1 year postOP), then decreased to 4,226 CHF (2 years postOP). The ICER for all aRCR patients was 24,924 CHF/QALY (95%CI: 16,742 to 33,106) and 17,357 CHF/QALY (95%CI: 10,951 to 23,763) and 36,474 CHF/QALY (95%CI: 16,301 to 56,648) for the Trauma-OP and Degen-OP groups, respectively. One-hundred-and-six from 110 working patients returned to work on average 77 days after surgery. Mean productivity losses for the aRCR group were 42,001 CHF per patient in the year before surgery and decreased to 5,415 CHF until 2 years after surgery. QOL and shoulder function were significantly associated (p < 0> Conclusions: For RC patients treated at a specialized Swiss orthopedic clinic, aRCR is a cost-effective intervention associated with clinically relevant improvement in QOL and productivity gains up to 2 years after repair compared to prior nonOP management.|
|Fulltext version:||Published version|
|License (according to publishing contract):||Licence according to publishing contract|
|Departement:||School of Management and Law|
|Organisational Unit:||Winterthur Institute of Health Economics (WIG)|
|Appears in collections:||Publikationen School of Management and Law|
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