Early health economic modelling of single-stage cartilage repair. Guiding implementation of technologies in regenerative medicine.

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)

Abstract

Both the complexity of clinically applied tissue engineering techniques for articular cartilage repair – such as autologous chondrocyte implantation (ACI) – plus increasing healthcare costs, and market competition, are forcing a shift in focus from two-stage to single-stage interventions that are more cost-effective. Early health economic models are expected to provide essential insight in the parameters driving the cost-effectiveness of new interventions before they are introduced into clinical practice. The present study estimated the likely incremental cost-effectiveness ratio (ICER) of a new investigator-driven single-stage procedure (IMPACT) compared with both microfracture and ACI, and identified those parameters that affect the cost-effectiveness. A decision tree with clinical health states was constructed. The ICER was calculated by dividing the incremental societal costs by the incremental Quality Adjusted Life Years (QALYs). Costs were determined from a societal perspective. A headroom analysis was performed to determine the maximum price of IMPACT compared with both ACI and microfracture, assuming a societal willingness to pay (WTP) of €30 000/QALY. One-way sensitivity analysis was performed to identify those parameters that drive the cost-effectiveness. The societal costs of IMPACT, ACI and microfracture were found to be €11 797, €29 741 and €6081, respectively. An 8% increase in all utilities after IMPACT changes the ICER of IMPACT vs. microfracture from €147 513/QALY to €28 588/QALY. Compared with ACI, IMPACT is less costly, which is largely attributable to the cell expansion procedure that has been rendered redundant. While microfracture can be considered the most cost-effective treatment option for smaller defects, a single-stage tissue engineering procedure can replace ACI to improve the cost-effectiveness for treating larger defects, especially if clinical non-inferiority can be achieved.
Original languageEnglish
Pages (from-to)2950-2959
JournalTissue engineering and regenerative medicine
Volume11
Issue number10
DOIs
Publication statusPublished - Oct 2017

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Regenerative Medicine
Cartilage
Cost effectiveness
Cost-Benefit Analysis
Chondrocytes
Stress Fractures
Repair
Economics
Health
Technology
Quality-Adjusted Life Years
Costs
Costs and Cost Analysis
Tissue Engineering
Tissue engineering
Health Care Costs
Economic Models
Decision Trees
Defects
Health Care Sector

Keywords

  • METIS-317382
  • IR-100898

Cite this

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title = "Early health economic modelling of single-stage cartilage repair. Guiding implementation of technologies in regenerative medicine.",
abstract = "Both the complexity of clinically applied tissue engineering techniques for articular cartilage repair – such as autologous chondrocyte implantation (ACI) – plus increasing healthcare costs, and market competition, are forcing a shift in focus from two-stage to single-stage interventions that are more cost-effective. Early health economic models are expected to provide essential insight in the parameters driving the cost-effectiveness of new interventions before they are introduced into clinical practice. The present study estimated the likely incremental cost-effectiveness ratio (ICER) of a new investigator-driven single-stage procedure (IMPACT) compared with both microfracture and ACI, and identified those parameters that affect the cost-effectiveness. A decision tree with clinical health states was constructed. The ICER was calculated by dividing the incremental societal costs by the incremental Quality Adjusted Life Years (QALYs). Costs were determined from a societal perspective. A headroom analysis was performed to determine the maximum price of IMPACT compared with both ACI and microfracture, assuming a societal willingness to pay (WTP) of €30 000/QALY. One-way sensitivity analysis was performed to identify those parameters that drive the cost-effectiveness. The societal costs of IMPACT, ACI and microfracture were found to be €11 797, €29 741 and €6081, respectively. An 8{\%} increase in all utilities after IMPACT changes the ICER of IMPACT vs. microfracture from €147 513/QALY to €28 588/QALY. Compared with ACI, IMPACT is less costly, which is largely attributable to the cell expansion procedure that has been rendered redundant. While microfracture can be considered the most cost-effective treatment option for smaller defects, a single-stage tissue engineering procedure can replace ACI to improve the cost-effectiveness for treating larger defects, especially if clinical non-inferiority can be achieved.",
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author = "{de Windt}, T.S. and J.C. Sorel and L.A. Vonk and Kip, {Michelle Maria Aleida} and IJzerman, {Maarten Joost} and Saris, {Dani{\"e}l B.F.}",
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Early health economic modelling of single-stage cartilage repair. Guiding implementation of technologies in regenerative medicine. / de Windt, T.S.; Sorel, J.C.; Vonk, L.A.; Kip, Michelle Maria Aleida; IJzerman, Maarten Joost; Saris, Daniël B.F.

In: Tissue engineering and regenerative medicine, Vol. 11, No. 10, 10.2017, p. 2950-2959.

Research output: Contribution to journalArticleAcademicpeer-review

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AU - de Windt, T.S.

AU - Sorel, J.C.

AU - Vonk, L.A.

AU - Kip, Michelle Maria Aleida

AU - IJzerman, Maarten Joost

AU - Saris, Daniël B.F.

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SN - 1738-2696

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