Cost-effectiveness of balloon kyphoplasty in patients with symptomatic vertebral compression fractures in a UK setting

Osteoporos Int. 2010 Sep;21(9):1599-608. doi: 10.1007/s00198-009-1096-6. Epub 2009 Nov 19.

Abstract

Summary: Balloon kyphoplasty (BKP) is a procedure used to treat vertebral compression fractures (VCFs). We developed a cost-effectiveness model to evaluate BKP in United Kingsdom patients with hospitalised VCFs and estimated the cost-effectiveness of BKP compared to non-surgical management. The results indicate that BKP provides a cost-effective alternative for treating these patients.

Introduction: VCFs of osteoporotic patients are associated with chronic pain, a reduction in health-related quality of life (QoL) and high healthcare costs. BKP is a minimally invasive procedure that has resulted in pain relief, vertebral body height-restoration, decreased kyphosis and improved physical functioning in patients with symptomatic VCFs. BKP was shown to improve health-related QoL in a 12-month interim analysis of a randomised phase-III trial.

Methods: The objectives of this study were to develop a Markov cost-effectiveness model to evaluate BKP in patients with painful hospitalised VCFs and to estimate the cost-effectiveness of BKP compared with non-surgical management in a UK setting. It was assumed that QoL-benefits found at 12 months linearly approached zero during another 2 years, and that patients receiving BKP warranted six fewer hospital bed days compared with patients given non-surgical management.

Results: The procedure was associated with quality-adjusted life-years (QALY)-gains of 0.17 and cost/QALY-gains at 8,800 pound sterling. The results were sensitive to assumptions about avoided length of hospital-stay and persistence of kyphoplasty-related QoL-benefits.

Conclusion: In conclusion, the results indicate that BKP provides a cost-effective alternative for treating patients with hospitalised VCFs in a UK-setting.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Catheterization / economics
  • Cost-Benefit Analysis
  • Female
  • Fractures, Compression / economics
  • Fractures, Compression / mortality
  • Fractures, Compression / surgery*
  • Health Care Costs / statistics & numerical data
  • Humans
  • Kyphoplasty / economics*
  • Kyphoplasty / methods
  • Length of Stay / statistics & numerical data
  • Male
  • Models, Econometric*
  • Osteoporotic Fractures / economics
  • Osteoporotic Fractures / mortality
  • Osteoporotic Fractures / surgery*
  • Quality of Life
  • Spinal Fractures / economics
  • Spinal Fractures / mortality
  • Spinal Fractures / surgery*
  • United Kingdom / epidemiology