Affiliation:
1. London School of Hygiene and Tropical
Medicine, 15-17 Tavistock Place, London, WC1H
9SH, UK.
Abstract
There is little evidence on the cost effectiveness of different brands of hip prostheses. We compared lifetime cost effectiveness of frequently used brands within types of prosthesis including cemented (Exeter V40 Contemporary, Exeter V40 Duration and Exeter V40 Elite Plus Ogee), cementless (Corail Pinnacle, Accolade Trident, and Taperloc Exceed) and hybrid (Exeter V40 Trilogy, Exeter V40 Trident, and CPT Trilogy). We used data from three linked English national databases to estimate the lifetime risk of revision, quality-adjusted life years (QALYs) and cost. For women with osteoarthritis aged 70 years, the Exeter V40 Elite Plus Ogee had the lowest risk of revision (5.9% revision risk, 9.0 QALYs) and the CPT Trilogy had the highest QALYs (10.9% revision risk, 9.3 QALYs). Compared with the Corail Pinnacle (9.3% revision risk, 9.22 QALYs), the most commonly used brand, and assuming a willingness-to-pay of £20 000 per QALY gain, the CPT Trilogy is most cost effective, with an incremental net monetary benefit of £876. Differences in cost effectiveness between the hybrid CPT Trilogy and Exeter V40 Trident and the cementless Corail Pinnacle and Taperloc Exceed were small, and a cautious interpretation is required, given the limitations of the available information. However, it is unlikely that cemented brands are among the most cost effective. Similar patterns of results were observed for men and other ages. The gain in quality of life after total hip arthroplasty, rather than the risk of revision, was the main driver of cost effectiveness. Cite this article: Bone Joint J 2015;97-B:762–70.
Publisher
British Editorial Society of Bone & Joint Surgery
Subject
Orthopedics and Sports Medicine,Surgery
Reference44 articles.
1. The operation of the century: total hip replacement
2. Surgeons' Knowledge about the Costs of Orthopaedic Implants
3. Can choices between alternative hip prostheses be evidence based? a review of the economic evaluation literature
4. No authors listed. Total hip replacement and surface replacement for the treatment of pain and disability resulting from end stage arthritis of the hip (Review of technology appraisal guidance 2 and 44). Warwick Evidence, 2013. http://guidance.nice.org.uk/TAG/307/Consultation/EvaluationReport/pdf/English (date last accessed 09 January 2015).
5. Effectiveness of hip prostheses in primary total hip replacement: a critical review of evidence and an economic model.
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