Cost-effectiveness of total hip and knee replacements for the Australian population with osteoarthritis: discrete-event simulation model

Higashi, Hideki and Barendregt, Jan J. (2011) Cost-effectiveness of total hip and knee replacements for the Australian population with osteoarthritis: discrete-event simulation model. PLoS ONE, 6 9: e25403. doi:10.1371/journal.pone.0025403


Author Higashi, Hideki
Barendregt, Jan J.
Title Cost-effectiveness of total hip and knee replacements for the Australian population with osteoarthritis: discrete-event simulation model
Journal name PLoS ONE   Check publisher's open access policy
ISSN 1932-6203
Publication date 2011-09-23
Sub-type Article (original research)
DOI 10.1371/journal.pone.0025403
Open Access Status DOI
Volume 6
Issue 9
Start page e25403
Total pages 11
Place of publication United States
Publisher Public Library of Science
Language eng
Formatted abstract
Background:
Osteoarthritis constitutes a major musculoskeletal burden for the aged Australians. Hip and knee replacement surgeries are effective interventions once all conservative therapies to manage the symptoms have been exhausted. This study aims to evaluate the cost-effectiveness of hip and knee replacements in Australia. To our best knowledge, the study is the first attempt to account for the dual nature of hip and knee osteoarthritis in modelling the severities of right and left joints separately.

Methodology/Principal Findings:
We developed a discrete-event simulation model that follows up the individuals with osteoarthritis over their lifetimes. The model defines separate attributes for right and left joints and accounts for several repeat replacements. The Australian population with osteoarthritis who were 40 years of age or older in 2003 were followed up until extinct. Intervention effects were modelled by means of disability-adjusted life-years (DALYs) averted. Both hip and knee replacements are highly cost effective (AUD 5,000 per DALY and AUD 12,000 per DALY respectively) under an AUD 50,000/DALY threshold level. The exclusion of cost offsets, and inclusion of future unrelated health care costs in extended years of life, did not change the findings that the interventions are cost-effective (AUD 17,000 per DALY and AUD 26,000 per DALY respectively). However, there was a substantial difference between hip and knee replacements where surgeries administered for hips were more cost-effective than for knees.

Conclusions/Significance:
Both hip and knee replacements are cost-effective interventions to improve the quality of life of people with osteoarthritis. It was also shown that the dual nature of hip and knee OA should be taken into account to provide more accurate estimation on the cost-effectiveness of hip and knee replacements.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Public Health Publications
 
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Created: Tue, 11 Oct 2011, 19:10:24 EST by Mr Hideki Higashi on behalf of School of Public Health