Cost-Effectiveness of Arthroplasty Management in Hip and Knee Osteoarthritis: a Quality Review of the Literature
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Osteoarthritis (T Appleton, Section Editor)
Cost-Effectiveness of Arthroplasty Management in Hip and Knee Osteoarthritis: a Quality Review of the Literature Codie A. Primeau, MSc1,2 Ishita Joshi, BHSc1,2 Bryn O. Zomar, MSc1,2 Lyndsay E. Somerville, PhD3,4 Holly T. Philpott, MSc1,2 David D. McHugh, BA1 Brent A. Lanting, MD2,3,4 Edward M. Vasarhelyi, MD2,3,4 Jacquelyn D. Marsh, PhD1,2,3,* Address *,1 Faculty of Health Sciences, University of Western Ontario, London, ON, N6G 1H1, Canada Email: [email protected] 2 Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre-University Hospital, London, ON, N6A 5B5, Canada 3 London Health Sciences Centre, University Hospital, London, ON, Canada 4 Department of Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
* Springer Nature Switzerland AG 2020 Key points • Evaluating cost-effectiveness of interventions is critical for providing value-based care for patients yet only 1 in 3 studies investigating costs within the hip and knee arthroplasty literature meet the criteria of a full economic evaluation necessary to appropriately draw conclusions on cost-effectiveness and inform policy decision-making. • Few studies (8%) compared surgical to non-surgical interventions. • Cost-effectiveness of treatments may be dependent on the perspective analyzed; therefore, transparency in reporting the costing perspective is necessary as overall costs vary substantially in the proportion of direct and indirect costs. • Consumers of economic evaluations in hip and knee arthroplasty literature need to assess the methodological quality of evidence, as many studies inappropriately conclude an intervention is “cost-effective” despite not conducting a full economic evaluation. This article is part of the Topical Collection on Osteoarthritis The online version of this article (https://doi.org/10.1007/s40674-020-00157-8) contains supplementary material, which is available to authorized users.
Osteoarthritis (T Appleton, Section Editor) Keywords Quality I Cost-effectiveness I Economic evaluation I Arthroplasty I Hip replacement I Knee replacement
Abstract Purpose of review Musculoskeletal disorders are a leading contributor to healthcare resource use and reduced quality of life, particularly in osteoarthritis of the hip/knee. Consequently, the volume of arthroplasty procedures continues to rise and there is a critical need to identify interventions that provide value-based care. Economic evaluations that assess both cost and health outcomes simultaneously allow clinicians and policymakers to make informed decisions regarding cost-effective interventions. The purpose of this review was to summarize and evaluate the methodological quality of economic evaluations of hip/knee interventions in arthroplasty. Recent findings We identified 384 studies. Two-thirds did not meet the criteria for full economic evaluations (compared costs independently). Several studies (28%) inappropriately concluded interventions were cost-effecti
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