TY - JOUR
T1 - Analysing uncertainty around costs of innovative medical technologies: the case of fibrin sealant (QUIXIL) for total knee replacement.
AU - Steuten, Lotte Maria Gertruda
AU - Vallejo-Torres, Laura
AU - Bastide, Philippe
AU - Buxton, Martin J.
PY - 2009
Y1 - 2009
N2 - This paper presents a relatively simple cost model comparing the costs of using a commercial fibrin sealant (QUIXIL®) in addition to conventional haemostatic treatment vs. conventional treatment alone in total knee replacement (TKR) surgery, and demonstrates and discusses how one- and two-way sensitivity analyses can inform decisions regarding an innovative medical technology, for which there is limited evidence on economic parameters. The model synthesises data from various sources and assesses the proportion of individuals likely to need blood transfusion, the resource use after TKR and transfusion-related adverse events.
Whether using fibrin sealant is cost saving strongly depends on the amount used, the achieved reduction in hospital length of stay (LOS) and price of QUIXIL®. If a 10-ml dose of fibrin sealant is required to achieve the effects as described in the published trials, its use adds cost, but if 25% or more of patients are treated with a 5-ml dose, its use becomes cost saving for the NHS. The sensitivity analyses provide clear guidance regarding parameters for additional data collection; design of future trials; and product pricing in relation to its effectiveness, and are likely to be preferred over more sophisticated approaches to inform medical device decision-making, particularly at the local level.
AB - This paper presents a relatively simple cost model comparing the costs of using a commercial fibrin sealant (QUIXIL®) in addition to conventional haemostatic treatment vs. conventional treatment alone in total knee replacement (TKR) surgery, and demonstrates and discusses how one- and two-way sensitivity analyses can inform decisions regarding an innovative medical technology, for which there is limited evidence on economic parameters. The model synthesises data from various sources and assesses the proportion of individuals likely to need blood transfusion, the resource use after TKR and transfusion-related adverse events.
Whether using fibrin sealant is cost saving strongly depends on the amount used, the achieved reduction in hospital length of stay (LOS) and price of QUIXIL®. If a 10-ml dose of fibrin sealant is required to achieve the effects as described in the published trials, its use adds cost, but if 25% or more of patients are treated with a 5-ml dose, its use becomes cost saving for the NHS. The sensitivity analyses provide clear guidance regarding parameters for additional data collection; design of future trials; and product pricing in relation to its effectiveness, and are likely to be preferred over more sophisticated approaches to inform medical device decision-making, particularly at the local level.
KW - IR-78173
KW - Decision Making
KW - Medical technology
KW - METIS-262880
KW - Sensitivity analysis
KW - Economic evaluation
KW - Total knee replacement
KW - Fibrin sealant
U2 - 10.1016/j.healthpol.2008.05.002
DO - 10.1016/j.healthpol.2008.05.002
M3 - Article
VL - 89
SP - 46
EP - 57
JO - Health policy
JF - Health policy
SN - 0168-8510
IS - 1
ER -