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Investigating the 7-Year Cost-Effectiveness of Single-Level Cervical Disc Replacement Compared to Anterior Cervical Discectomy and Fusion
| Content Provider | SAGE Publishing |
|---|---|
| Author | McAnany, Steven J. Merrill, Robert K. Overley, Samuel C. Kim, Jun S. Brochin, Robert L. Qureshi, Sheeraz A. |
| Copyright Year | 2017 |
| Abstract | Study Design:Cost-effectiveness analysis.Objectives:To determine the 7-year cost-effectiveness of cervical disc replacement (CDR) and anterior cervical discectomy and fusion (ACDF).Methods:We analyzed 7-year Short Form-36 Health Survey data collected from the Prestige Cervical Disc investigational device exemption study (IDE). The SF-6D algorithm was used to convert this data into health state utilities. Costs were calculated from the payer perspective, and quality adjusted life years (QALYs) were used to represent effectiveness. A Markov transition-state model was used to evaluate the cost-effectiveness of single-level CDR versus ACDF, and a Monte Carlo simulation was performed to assess the probabilistic sensitivity of the model.Results:CDR generated a 7-year cost of $172 989 compared to a 7-year cost of $143 714 for ACDF. CDR generated 4.53 QALYs compared to 3.85 QALYs generated by ACDF. The cost-effectiveness ratio of CDR was $38 247/QALY, while the cost-effectiveness ratio of ACDF was $37 325/QALY. The incremental cost-effectiveness ratio of CDR was $43 522/QALY, under the willingness to pay threshold of $50 000/QALY. Our probabilistic sensitivity analysis demonstrated CDR would be chosen 56% of the time based on 10 000 simulations.Conclusions:Single-level CDR and ACDF were both cost-effective strategies at 7 years for treating degenerative conditions of the cervical spine. Both the Markov simulation and the Monte Carlo simulation demonstrate CDR to be the more cost-effective strategy at 7 years. Continued analysis of IDE data should be performed to validate long-term cost-effectiveness of these treatment strategies. |
| Related Links | https://journals.sagepub.com/doi/pdf/10.1177/2192568217726283?download=true |
| Starting Page | 32 |
| Ending Page | 39 |
| Page Count | 8 |
| ISSN | 21925682 |
| Issue Number | 1 |
| Volume Number | 8 |
| Journal | Global Spine Journal (GSJ) |
| e-ISSN | 21925690 |
| DOI | 10.1177/2192568217726283 |
| Language | English |
| Publisher | Sage Publications CA |
| Publisher Date | 2017-08-17 |
| Publisher Place | Los Angeles |
| Access Restriction | Open |
| Rights Holder | © The Author(s) 2017 |
| Subject Keyword | anterior cervical discectomy and fusion cervical disc replacement ACDF cost-effectiveness CDR |
| Content Type | Text |
| Resource Type | Article |
| Subject | Orthopedics and Sports Medicine Neurology (clinical) Surgery |
