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The Budget Impact of Introducing Demineralised Bone Matrix Combined with Local Bone to Replace Currently Available Treatments for Lumbar Spinal Fusion Procedures in Spain
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
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2017 (English)In: Value in Health, ISSN 1098-3015, E-ISSN 1524-4733, Vol. 20, no 9, p. A530-A530Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Objectives: Estimate the budget impact (BI) of introducing demineralised bone matrix (DBM) combined with local bone (LB) in lumbar spinal fusion to treat lumbar degenerative disk disease in Spain. Methods: A decision tree model was developed to evaluate the 4-year BI associated with introducing LB combined with DBM putty (LB+DBM) to replace currently available treatment options including iliac crest bone graft (ICBG), LB alone, and LB combined with ceramic bone graft extenders (LB+ceramic). The market shares of the currently available treatments were 30% ICBG, 40% LB, and 30% LB+ceramic respectively. The analysis was conducted for 100 patients assuming LB+DBM would replace the currently administered treatment mix. Patients receiving DBM were administered 5cc and those receiving ceramics were administered 10cc beta-tricalcium phosphate. The model structure was based on previously published models identified through a structured literature search. The cost of DBM, ceramic, surgical procedures, adverse events, treatment failure, and reoperations were ncluded in the base-case analysis, and productivity loss was analysed in sensitivity analysis. Costs were sourced for Spain in €2017 and no discounting was applied. The model’s inputs and assumptions were validated by two Spanish clinical experts. Results: Over 4 years, replacing currently available treatments with LB+DBM spinal fusions resulted in an additional cost of €12,330 (€123/patient) and an additional 14 successful fusions, implying a cost of €881 per additional successful fusion. Initial procedure costs were higher for LB+DBM, but result in subsequent cost savings in terms of reoperations and adverse events. When including costs of productivity loss, the introduction of LB+DBM resulted in cost savings of €70,294 (€703/patient). Conclusions: For patients eligible for lumbar spinal fusion in Spain, replacing currently available treatments with LB+DBM results in increased costs for the payer but cost savings for society, while providing more successful fusions in both cases.

Place, publisher, year, edition, pages
ELSEVIER SCIENCE INC , 2017. Vol. 20, no 9, p. A530-A530
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:umu:diva-143155DOI: 10.1016/j.jval.2017.08.744ISI: 000413599901094OAI: oai:DiVA.org:umu-143155DiVA, id: diva2:1168326
Conference
ISPOR 20th Annual European Congress, 4–8 November 2017, Glasgow, Scotland
Available from: 2017-12-20 Created: 2017-12-20 Last updated: 2018-06-09Bibliographically approved

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Geale, Kirk

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