Samuelson, Arthroscopy 2016 - The Cost-Effectiveness of Using Platelet-Rich Plasma during Rotator Cuff Repair: A Markov Model Analysis

The Cost-Effectiveness of Using Platelet-Rich Plasma during Rotator Cuff Repair: A Markov Model Analysis

Samuelson, Fleischli, et al.·Arthroscopy·2016·44 citations

Purpose

To perform a cost-utility analysis to determine if the use of platelet-rich plasma (PRP) products during arthroscopic rotator cuff repair (RCR) is cost-effective.

Methods

A cost-utility analysis was conducted using a Markov decision model.
Model inputs including health utility values, retear rates, and transition probabilities were derived from the best evidence available in the literature regarding full-thickness rotator cuff tears and their repair, as well as the augmentation of their repair with PRP.
Costs were determined by examining the typical patient undergoing treatment for a full-thickness rotator cuff tear in a private orthopaedic clinic and outpatient surgery center.

Results

The cost per quality-adjusted life-year ($/QALY) of RCR with and without PRP was $6,775/QALY and $6,612/QALY, respectively.
In our base case, the use of PRP to augment RCR was not cost-effective because it had exactly the same "effectiveness" as RCR without PRP augmentation while being associated with a higher cost (additional $750).
Sensitivity analysis showed that to achieve a willingness-to-pay threshold of $50,000/QALY, the addition of PRP would need to be associated with a 9.1% reduction in retear rates.
If the cost of PRP were increased to $1,000, the retear rate would need to be reduced by 12.1% to reach this same threshold.
This compared with a necessary reduction of only 6.1% if the additional cost of PRP was $500.

Conclusions

This cost-utility analysis shows that, currently, the use of PRP to augment RCR is not cost-effective. Sensitivity analysis showed that PRP-augmented repairs would have to show a reduced retear rate of at least 9.1% before the additional cost would be considered cost-effective.

Level of evidence: Level III, analysis of Level I, II, and III studies. Copyright remains with the authors and publisher.

Supplemental

The Cost-Effectiveness of Using Platelet-Rich Plasma during Rotator Cuff Repair: A Markov Model Analysis.

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The Cost-Effectiveness of Using Platelet-Rich Plasma during Rotator Cuff Repair: A Markov Model Analysis

Samuelson, Fleischli, et al.·Arthroscopy·2016·44 citations

DOI·PubMed

Purpose

To perform a cost-utility analysis to determine if the use of platelet-rich plasma (PRP) products during arthroscopic rotator cuff repair (RCR) is cost-effective.

Methods

A cost-utility analysis was conducted using a Markov decision model.
Model inputs including health utility values, retear rates, and transition probabilities were derived from the best evidence available in the literature regarding full-thickness rotator cuff tears and their repair, as well as the augmentation of their repair with PRP.
Costs were determined by examining the typical patient undergoing treatment for a full-thickness rotator cuff tear in a private orthopaedic clinic and outpatient surgery center.

Results

The cost per quality-adjusted life-year ($/QALY) of RCR with and without PRP was $6,775/QALY and $6,612/QALY, respectively.
In our base case, the use of PRP to augment RCR was not cost-effective because it had exactly the same "effectiveness" as RCR without PRP augmentation while being associated with a higher cost (additional $750).
Sensitivity analysis showed that to achieve a willingness-to-pay threshold of $50,000/QALY, the addition of PRP would need to be associated with a 9.1% reduction in retear rates.
If the cost of PRP were increased to $1,000, the retear rate would need to be reduced by 12.1% to reach this same threshold.
This compared with a necessary reduction of only 6.1% if the additional cost of PRP was $500.

Conclusions

Level of evidence: Level III, analysis of Level I, II, and III studies. Copyright remains with the authors and publisher.

Purpose

To perform a cost-utility analysis to determine if the use of platelet-rich plasma (PRP) products during arthroscopic rotator cuff repair (RCR) is cost-effective.

Methods

A cost-utility analysis was conducted using a Markov decision model.
Model inputs including health utility values, retear rates, and transition probabilities were derived from the best evidence available in the literature regarding full-thickness rotator cuff tears and their repair, as well as the augmentation of their repair with PRP.
Costs were determined by examining the typical patient undergoing treatment for a full-thickness rotator cuff tear in a private orthopaedic clinic and outpatient surgery center.

Results

The cost per quality-adjusted life-year ($/QALY) of RCR with and without PRP was $6,775/QALY and $6,612/QALY, respectively.
In our base case, the use of PRP to augment RCR was not cost-effective because it had exactly the same "effectiveness" as RCR without PRP augmentation while being associated with a higher cost (additional $750).
Sensitivity analysis showed that to achieve a willingness-to-pay threshold of $50,000/QALY, the addition of PRP would need to be associated with a 9.1% reduction in retear rates.
If the cost of PRP were increased to $1,000, the retear rate would need to be reduced by 12.1% to reach this same threshold.
This compared with a necessary reduction of only 6.1% if the additional cost of PRP was $500.

Conclusions

Level of evidence: Level III, analysis of Level I, II, and III studies. Copyright remains with the authors and publisher.

Purpose

To perform a cost-utility analysis to determine if the use of platelet-rich plasma (PRP) products during arthroscopic rotator cuff repair (RCR) is cost-effective.

Methods

A cost-utility analysis was conducted using a Markov decision model.
Model inputs including health utility values, retear rates, and transition probabilities were derived from the best evidence available in the literature regarding full-thickness rotator cuff tears and their repair, as well as the augmentation of their repair with PRP.
Costs were determined by examining the typical patient undergoing treatment for a full-thickness rotator cuff tear in a private orthopaedic clinic and outpatient surgery center.

Results

The cost per quality-adjusted life-year ($/QALY) of RCR with and without PRP was $6,775/QALY and $6,612/QALY, respectively.
In our base case, the use of PRP to augment RCR was not cost-effective because it had exactly the same "effectiveness" as RCR without PRP augmentation while being associated with a higher cost (additional $750).
Sensitivity analysis showed that to achieve a willingness-to-pay threshold of $50,000/QALY, the addition of PRP would need to be associated with a 9.1% reduction in retear rates.
If the cost of PRP were increased to $1,000, the retear rate would need to be reduced by 12.1% to reach this same threshold.
This compared with a necessary reduction of only 6.1% if the additional cost of PRP was $500.

Conclusions

Level of evidence: Level III, analysis of Level I, II, and III studies. Copyright remains with the authors and publisher.