Abstract:
STUDY DESIGN:A propensity score matching study. OBJECTIVE:The aim of this study was to assess the cost-effectiveness of balloon kyphoplasty (BKP) in Japan. SUMMARY OF BACKGROUND DATA:Osteoporotic vertebral fracture (OVF) is a common disease in elderly people. In Japan, the incidence of painful OVF in 2008 was estimated as 880,000, and approximately 40% of patients with painful OVF are hospitalized due to the severity of pain. Japan is the front runner among super-aged societies and rising health care costs are an economic problem. METHODS:BKP and nonsurgical management (NSM) for acute/subacute OVF were performed in 116 and 420 cases, respectively. Quality-adjusted life years (QALY) and incremental costs were calculated on the basis of a propensity score matching study. QALY was evaluated using the SF-6D questionnaire. Finally, using a Markov model, incremental cost-effectiveness ratios (ICERs) were calculated for 71 matched cases. RESULTS:In the comparison between BKP and NSM, mean patients age was 78.3 and 77.7 years, respectively (P = 0.456). The BKP procedure cost 402,988 JPY more than NSM and the gains in QALY at the 6-month follow-up were 0.153 and 0.120, respectively (difference = 0.033). ICERs for 3 and 20 years were 4,404,158 JPY and 2,416,406 JPY, respectively. According to sensitivity analysis, ICERs ranged from 652,181 JPY to 4,896,645 JPY (4418-33,168 GBP). CONCLUSION:This study demonstrated that BKP is a cost-effective treatment option for OVF in Japan. However, the effect might be blunted in patients aged > 80 years. Further research is necessary to elucidate the cost-effectiveness of BKP in this population. LEVEL OF EVIDENCE:4.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Takahashi S,Hoshino M,Yasuda H,Terai H,Hayashi K,Tsujio T,Kono H,Suzuki A,Tamai K,Ohyama S,Toyoda H,Dohzono S,Kanematsu F,Hori Y,Nakamura Hdoi
10.1097/BRS.0000000000002829subject
Has Abstractpub_date
2019-03-01 00:00:00pages
E298-E305issue
5eissn
0362-2436issn
1528-1159pii
00007632-201903010-00016journal_volume
44pub_type
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