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Cost-utility analysis indicates reverse TSA is cost-effective for treatment of proximal humerus fractures
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Results from this cost-utility analysis found reverse total shoulder arthroplasty may be a cost-effective treatment option for patients with complex proximal humerus fractures.
Researchers used a Markov model for a simulation of treatment options for patients with proximal humerus fractures necessitating surgery but could not be treated with fixation. Investigators looked at subsequent health and economic outcomes. Surgery costs were expressed in U.S. dollars with quality-adjusted life-years (QALY) for effectiveness. The incremental cost-effectiveness ratio (ICER) was the primary outcome. Investigators evaluated the assumptions of the models with a sensitivity analysis.
Findings showed reverse total shoulder arthroplasty (TSA) for the payer was correlated with an ICER of $8,100/QALY. Investigators noted they excluded hemiarthroplasty from the payer analysis. According to researchers, hemiarthroplasty was not cost-effective from a hospital perspective with an ICER of $36,7000/QALY; however, reverse TSA had an ICER of $57,400/QALY from the hospital perspective.
In the payer and hospital sensitivity analyses, reverse TSA was the optimal strategy in 61% and 54%, respectively. According to researchers, the preferred treatment option was dependent on correlated QALY gains, the cost for primary reverse TSA and rates of failure for reverse TSA. ‒ by Monica Jaramillo
Disclosures: Nwachukwu reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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