The value of medical 3D printing : hope versus hype

Abstract

3D printing has been growing fast in the medical field. While preliminary clinical results have been reported in the literature, it’s health economic value has not been analyzed yet. Medical 3D printing has found its main applications in surgery; especially orthopedics and reconstructive surgery. Its applications rage from anatomic models to surgical guides and implants. All of these can be seen as consecutive levels of integration. While papers often report improved clinical results, a great accuracy and an acceptable price, few of these are backed with numbers. We performed 3 health economic analyses using Markov models using a payer perspective on each of these 3 levels of integration. As a first level, we analyzed the impact of using anatomic models as a tool for surgical planning in congenital heart diseases for 9 different procedures. Results varied from not being cost effective for atrial septum defects, to being highly cost-effective in highly complex procedures such as a Norwood repair. Second, we analyzed the already well integrated use of surgical guides for primary total knee arthroplasty using Belgian registry data. The database approach showed an significantly reduced revision rate in the group using custom guides compared to the conventional approach. The Markov models showed the technology to be cost-effective if CT-based guides are used. At last, we analyzed the use of custom 3D printed acetabular implants for revision surgery in patients with acetabular defects compared to non-3D printed custom implants. The 3D printed implants showed to be cost effective, especially in younger patients. The final chapter gives an overview of the pitfalls encountered during these preliminary analyses and gives a glance at possible solutions to allow better analysis and faster adoption of medical innovations