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2016 ; 8
(ä): 1-14
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Cost-effectiveness of minimally invasive sacroiliac joint fusion
#MMPMID26719717
Cher DJ
; Frasco MA
; Arnold RJ
; Polly DW
Clinicoecon Outcomes Res
2016[]; 8
(ä): 1-14
PMID26719717
show ga
BACKGROUND: Sacroiliac joint (SIJ) disorders are common in patients with chronic
lower back pain. Minimally invasive surgical options have been shown to be
effective for the treatment of chronic SIJ dysfunction. OBJECTIVE: To determine
the cost-effectiveness of minimally invasive SIJ fusion. METHODS: Data from two
prospective, multicenter, clinical trials were used to inform a Markov process
cost-utility model to evaluate cumulative 5-year health quality and costs after
minimally invasive SIJ fusion using triangular titanium implants or non-surgical
treatment. The analysis was performed from a third-party perspective. The model
specifically incorporated variation in resource utilization observed in the
randomized trial. Multiple one-way and probabilistic sensitivity analyses were
performed. RESULTS: SIJ fusion was associated with a gain of approximately 0.74
quality-adjusted life years (QALYs) at a cost of US$13,313 per QALY gained. In
multiple one-way sensitivity analyses all scenarios resulted in an incremental
cost-effectiveness ratio (ICER) <$26,000/QALY. Probabilistic analyses showed a
high degree of certainty that the maximum ICER for SIJ fusion was less than
commonly selected thresholds for acceptability (mean ICER =$13,687, 95%
confidence interval $5,162-$28,085). SIJ fusion provided potential cost savings
per QALY gained compared to non-surgical treatment after a treatment horizon of
greater than 13 years. CONCLUSION: Compared to traditional non-surgical
treatments, SIJ fusion is a cost-effective, and, in the long term, cost-saving
strategy for the treatment of SIJ dysfunction due to degenerative sacroiliitis or
SIJ disruption.