Table 1 Economic evaluation summary evidence table
No. | Author & year | Country | Intervention (s) | Comparator (s) | Study design | Economic study type | Perspective | Study population | Measure of effectiveness | Cost types / Currency / Price year | Discount rates |
|---|---|---|---|---|---|---|---|---|---|---|---|
1. | Bedair et al, [18] | USA | Total knee arthroplasty (TKA) | Non-operative treatment | Markov model | CBA | Societal | Severe unilateral knee OA | Cost saving approximately 3.5 years after surgery | Direct and indirect costs / US dollar / 2012 | 3% for costs and effects |
2. | Bozic et al, [29] | USA | Metal-on-metal hip resurfacing arthroplasty (MoM-HRA) | Total hip arthroplasty (THA) | Markov model | CUA | Healthcare system | Patients with advanced hip OA | QALYs | Direct costs / US dollar / price year not clearly stated (2008/2009) | 5% for costs and effects |
3. | Di Tanna et al, [39] | Italy | Cementless fixation technique for THA | Hybrid fixation technique for THA | Markov model | CEA | Healthcare provider | Patients with hip OA undergoing THA | "revision-free" life year | Only prosthesis, surgical and revision costs / Euro / price year not stated | 3.5% for costs and effects |
4. | Heintzbergen et al, [37] | Canada | MoM-HRA | Conventional THA | Markov model | CUA | Healthcare system | Patients with hip OA undergoing hip arthroplasty | QALYs | Direct costs / Canadian dollar / 2011 | 3% for costs and effects |
5. | Higashi et al, [35] | Australia | Total replacement of hips and knees | ‘Doing nothing’ (non-surgical therapies without joint replacements) | Discrete event simulation model | CUA | Healthcare system | 68,908 with hip OA and 100,657 with knee OA | DALYs (disability-adjusted life-years) | Direct costs / Australian dollar / 2003 | 3% for costs and effects |
6. | Koskinen et al, [21] | Finland | Unicondylar arthroplasty (UKA) | TKA | Register-based analysis | CEA | Not mentioned | Knee OA patients undergoing either UKA or TKA or both | "revision-free" life year | Only prosthesis costs (3 different UKA implants) / Euro / 2003 | Nil |
7. | Li et al, [22] | Germany | KineSpring Knee Implant System | No treatment, conventional treatments or other surgical interventions for knee OA | Not reported | CUA | Not mentioned | Mild-to-moderate knee OA patients (not eligible for TKA /UKA) | QALYs | Direct and indirect costs (no details given) / Euro / 2012 | Nil |
8. | Losina et al, [36] | USA | TKA done in low, medium & high volume hospitals | No TKA performed | Markov model | CUA | Societal | Patients with end-stage knee OA for TKA | QALYs | Direct and indirect costs / US dollar / 2006 | 3% for costs and effects |
9. | Mota, [38] | Italy | Early primary THA | 1. Non-surgical then primary THA 2. Non-surgical with NSAIDs | Markov model | CUA | Healthcare provider | Patients with hip OA undergoing hip arthroplasty | QALYs | Direct costs / Euro / 2010 | 3% for costs and effects |
10. | Pennington et al, [41] | UK / England | Cementless and hybrid prosthesis for THA | Cemented prosthesis for THA | Markov model | CUA | Healthcare system | OA patients aged 55 to 84 undergoing THA | QALYs | Direct costs only / British pound sterling / 2010-2011 | 3.5% for costs and effects |
11. | Räsänen et al, [28] | Finland | 1. Primary THA 2. Secondary / revision THA 3. Primary TKA | Non-operative intervention | Cohort-based study | CUA | Healthcare provider | Cohort of patients from 30 medical entities in Finland | QALYs | Direct hospital costs only / Euro / price year not stated | 5% for effects (QALY) only |
12. | Ruiz et al, [31] | USA | TKA | Non-operative treatment | Markov model | CUA | Societal | Adults aged 40 years old and older undergoing TKA for knee OA in the USA in 2009 | QALYs | Direct and indirect costs / US dollar / 2009 | 3% for costs and effects |
13. | SooHoo et al, [25] | USA | UKA | TKA | Decision tree | CUA | Societal | Unicompart-mental knee OA patients | QALYs | Direct costs only / US dollar / 1998 | 3% for costs and effects |
14. | Suter et al, [26] | USA | “innovative” TKA implants (highly crossed-linked polyethylene or other innovative biomaterials) | “standard” implants (an ultra-high molecular weight all polyethylene tibial component) | Markov analysis based on Osteoarthri-tis Policy (OAPol) Model | CUA | Societal | Adults with symptomatic end stage knee OA needing TKA | QALYs | Direct costs only / US dollar / 2010 | 3% for costs and effects |
15. | Waimann et al, [32] | USA | TKA | Hypothetical nonsurgery strategy | Cohort-based study | CEA | Societal | 212 patients with knee OA who under-went TKR. | Improvement in WOMAC score | Direct and indirect costs / US dollar / 2007 | Nil |
16. | Xie et al, [27] | Canada & Singapore | TKA | UKA | Cohort-based study (hospital in Singapore) | CUA | Societal | 431 TKR patients and 102 UKA patients | QALYs | Direct costs only / US dollar / 2008 | Nil |
17. | Konopka et al, [33] | USA | HTO and UKA | TKA | Markov model | CUA | Societal | Patients with knee OA requiring surgery | QALYs | Direct and indirect costs / US dollar / 2012 | 3% for costs and effects |
18. | Marsh et al, [19] | Canada | Arthroscopic surgery in addition to non-operative treatments | Non-operative treatments alone (optimised physical and medical therapy) | Alongside RCT | CEA and CUA | Healthcare and societal | Patients with knee OA | WOMAC Index QALYs | Direct and indirect costs / Canadian dollar / 2014 | Nil |
19. | Mather et al, [20] | USA | Primary TKA without delay | Delayed TKA (with and without non-operative bridge treatment) | Markov model | CUA | Healthcare and societal | End-stage knee OA | QALYs | Direct and indirect costs / US dollar / 2009 | 3% |
20. | Peersman et al, [34] | Belgium | UKA | TKA | Markov model | CUA | Healthcare | Patients with unicondylar knee OA | QALYs | Direct costs / Euro / 2014 | 1.5% and 3% |
21. | Pennington et al, [23] | UK | Different brands within types of hips prosthesis (cemented, cementless and hybrid) | - | Markov model | CUA | Not mentioned | Patients with hip OA requiring primary THA | QALYs | Direct costs / British pounds sterling / 2010/2011 | 3.5% |
22. | Pulikottil-Jacob et al, [40] | UK | Combinations of components in hip prosthesis for THA, including the type of fixation and bearing surfaces | - | Markov model | CUA | NHS and Personal Social Services | Patients undergoing THA for hip OA | QALYs | Direct costs / British pound sterling / 2012 | 3.5% |
23. | Stan et al, [24] | Romania | Unilateral TKA and TKA following HTO | Rehabilitation care | Alongside clinical trial | CUA | Not mentioned | Patients with knee OA | QALYs | Direct costs / Euro / year not mentioned | 3% (outcome only) |