Cost Utility Analysis of Balloon Kyphoplasty and Vertebroplasty in the Treatment of Vertebral Compression Fractures in the United States
Vertebral compression fractures are associated with chronic pain, decreased health related quality of life and high health care costs. Balloon kyphoplasty and vertebroplasty are vertebral augmentation procedures, widely used by spine surgeons to relieve pain in these patients. A number of studies have been conducted to compare and contrast the effectiveness of both these techniques and have reported that balloon kyphoplasty offers a long lasting pain relief compared to vertebroplasty. However, kyphoplasty procedure is also more expensive than vertebroplasty. With the limited resources and the need of justification of patient selection, it is important to address whether the additional benefits offered by kyphoplasty are worth the additional costs. We performed a cost utility analysis from a payer’s perspective using a Markov model to assess the cost utility of balloon kyphoplasty compared to vertebroplasty. Health utility data was obtained from previously conducted clinical trials. Direct medical cost associated with each of these procedures were obtained through an observational study conducted from the payer’s perspective. Sensitivity analysis was performed to assess the robustness of the results around uncertainties in cost and utility parameters. The incremental cost utility of balloon kyphoplasty was $ 29,027. The results were found to be robust. In conclusion, balloon kyphoplasty is a cost-effective option for treating patients with vertebral compression fractures in the United States at a willingness-to-pay threshold of $50,000.
Pharmacy Sciences, Vertebral compression fractures, Vertebroplasty, Kyphoplasty, Cost-effectiveness, Cost-utility analyis, Markov model
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