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Blissett DB, Blissett RS, Ede MPN, et al. Minimally Invasive Sacroiliac Joint Fusion with Triangular Titanium Implants: Cost-Utility Analysis from NHS Perspective. Pharmacoecon Open. 2020;5(2):197-209doi: 10.1007/s41669-020-00236-5.
Blissett, D. B., Blissett, R. S., Ede, M. P. N., Stott, P. M., Cher, D. J., & Reckling, W. C. (2021). Minimally Invasive Sacroiliac Joint Fusion with Triangular Titanium Implants: Cost-Utility Analysis from NHS Perspective. PharmacoEconomics - open, 5(2), 197-209. https://doi.org/10.1007/s41669-020-00236-5
Blissett, Deirdre B, et al. "Minimally Invasive Sacroiliac Joint Fusion with Triangular Titanium Implants: Cost-Utility Analysis from NHS Perspective." PharmacoEconomics - open vol. 5,2 (2021): 197-209. doi: https://doi.org/10.1007/s41669-020-00236-5
Blissett DB, Blissett RS, Ede MPN, Stott PM, Cher DJ, Reckling WC. Minimally Invasive Sacroiliac Joint Fusion with Triangular Titanium Implants: Cost-Utility Analysis from NHS Perspective. Pharmacoecon Open. 2021 Jun;5(2):197-209. doi: 10.1007/s41669-020-00236-5. Epub 2020 Nov 09. PMID: 33165824; PMCID: PMC8160075.
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Pharmacoecon Open. 2021 Jun;5(2):197-209. doi: 10.1007/s41669-020-00236-5. Epub 2020 Nov 09.

Minimally Invasive Sacroiliac Joint Fusion with Triangular Titanium Implants: Cost-Utility Analysis from NHS Perspective.

PharmacoEconomics - open

Deirdre B Blissett, Rob S Blissett, Matthew P Newton Ede, Philip M Stott, Daniel J Cher, W Carlton Reckling

Affiliations

  1. MedTech Economics Ltd., Winchester, UK. [email protected].
  2. MedTech Economics Ltd., Winchester, UK.
  3. The Royal Orthopaedic Hospital, Bristol Road South, Birmingham, UK.
  4. Precision Spine, 81 Harborne Road, Edgbaston, Birmingham, UK.
  5. Brighton and Sussex University Hospitals NHS Trust, Eastern Road, Brighton, UK.
  6. Department of Clinical Affairs, SI-BONE, Inc., San Jose, CA, USA.
  7. Department of Medical Affairs, SI-BONE, Inc., San Jose, CA, USA.

PMID: 33165824 PMCID: PMC8160075 DOI: 10.1007/s41669-020-00236-5

Abstract

OBJECTIVE: The aim was to identify the cost-effectiveness of minimally invasive sacroiliac joint fusion (MI SIJF) surgery with titanium triangular implants for patients with sacroiliac joint (SIJ) pain who have failed conservative management, compared to non-surgical management (NSM) from a National Health Service (NHS) England perspective.

METHODS: Over a time horizon of 5 years, a cohort state transition model compared the costs and outcomes of treating patients with MI SIJF to those of traditional NSM treatment pathways. The NSM arm included two treatments: grouped physical therapy and corticosteroid injections (PTSI) or radiofrequency ablation (RFA). Three different strategies were considered: (1) a stepped pathway, (2) patients split between PTSI and RFA, and (3) RFA only. The outcome measure was incremental cost-effectiveness ratio (ICER), reported in 2018 British pounds per quality-adjusted life year (QALY) gained. One-way and probabilistic sensitivity analyses were used to test the robustness of the model results.

RESULTS: Patients undergoing MI SIJF accrued total procedure-related and pain-management costs of £8358, while NSM treatment strategy 1 had total costs of £6880. The MI SIJF cohort had 2.98 QALYs compared to strategy 1 with 2.30 QALYs. This resulted in an ICER for MI SIJF versus strategy 1 of £2164/QALY gained. Strategy 2 of the NSM arm had lower costs than strategy 1 (£6564) and 2.26 QALYs, and this resulted in an ICER of £2468/QALY gained for MI SIJF. Strategy 3 of the NSM arm had lower costs than strategy 1 (£6580), and this resulted in 2.28 QALYs and an ICER of £2518/QALY gained for MI SIJF. Probabilistic sensitivity analysis shows that at a threshold of £20,000/QALY gained, MI SIJF has a probability of being cost-effective versus NSM strategies of 96%, 97%, and 91% for strategies 1, 2, and 3, respectively.

CONCLUSION: MI SIJF appears to be cost-effective over a 5-year time horizon when compared to traditional NSM pathways in an NHS context.

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