Economic evaluation of access to musculoskeletal care: the case of waiting for total knee arthroplasty

Table 2 Results of analysis for base case

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
B	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.

ISSN: 1471-2474