|
Cost scenario
| |
Avg. cost
|
Avg. QALYs gained
|
Avg. cost difference
|
Avg. difference in QALYs gained
|
Cost-effectiveness ratio
|
Incremental cost-effectiveness ratio
|
|---|
|
A
|
TKA without delay
|
$17,840
|
12.18
|
$1,667
|
0.61
|
$1,464/QALY
|
$2,723/QALY
|
|
Delayed TKA with Nonop Bridge
|
$21,230
|
11.76
|
$3,398
|
0.19
|
$1,806/QALY
|
$17,880/QALY*
|
|
Delay + No Bridge
|
$16,170
|
11.57
|
-
|
-
|
$1,398/QALY
|
-
|
|
B
|
TKA without delay
|
$59,640
|
12.18
|
-
|
0.61
|
$4,897/QALY
| |
|
Delayed TKA with Nonop Bridge
|
$78,541
|
11.76
|
$18,900
|
0.19
|
$6,679/QALY
|
DOMINATED**
|
| |
Delay + No Bridge
|
$73,477
|
11.57
|
$13,836
|
-
|
$6,351/QALY
|
DOMINATED**
|
- Cost scenario A = Direct costs only, Cost scenario B = Indirect costs included
- *Waiting with a non-operative bridge resulted in a lower number of average quality-adjusted life-years gained while also at a higher average cost to the payer and is, therefore, “DOMINATED” by the TKA without delay strategy for the treatment of end-stage knee osteoarthritis in the base case. It is considered cost effective compared to delayed TKA with no treatment bridge.
- **When indirect costs are considered, TKA without delay is both less costly and more effective than the other two strategies and is therefore a dominant treatment strategy.
