6 research outputs found
PMD46 Doctor Knows Best: The Effect of Yea-Saying Bias on Willingness to Pay in Choice-Format Conjoint-Analysis Studies
Cost-utility of metal-on-metal hip resurfacing compared to conventional total hip replacement in young active patients with osteoarthritis
Background: Metal-on-metal hip resurfacing arthroplasty (MoM HRA) has emerged as an alternative to total hip arthroplasty (THA) for younger active patients with osteoarthritis (OA). Birmingham hip resurfacing is the most common MoM HRA in Alberta, and is therefore compared with conventional THA. Objective: The objective of this study was to estimate the expected cost utility of MoM HRA versus THA, in younger patients with OA, using a decision analytic model with a 15-year time horizon. Methods: A probabilistic Markov decision analytic model was constructed to estimate the expected cost per quality-adjusted life-year (QALY) of MoM HRA versus THA from a health care payer perspective. The base case considered patients with OA aged 50 years; men comprised 65.9% of the cohort. Sensitivity analyses evaluated cohort age, utility values, failure probabilities, and treatment costs. Data were derived from the Hip Improvement Project and the Hip and Knee Replacement Pilot databases in Alberta, the 2010 National Joint Replacement Registry of the Australian Orthopaedic Association, and the literature. Results: In the base case, THA was dominated by MoM HRA (incremental mean costs of -50,000/QALY, there was a 58% probability that MoM HRA is cost-effective. Conclusions: The results show that, on average, MoM HRA was preferred to THA for younger and male patients, but THA is still a reasonable option if the patient or clinician prefers given the small absolute differences between the options and the confidence ellipses around the cost-effectiveness estimates