Cost-effectiveness analysis of robotic-arm assisted total knee arthroplasty (TKA) versus conventional TKA in Iranian population

Abstract Objective The costs of robot-assisted surgery are high compared to traditional surgeries, the main objective of this study is to investigate the cost-effectiveness of robotic total knee arthroplasty (rTKA) and manual total knee arthroplasty (mTKA) in Iran. Method The economic evaluation car...

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Main Authors: Zahra Goudazi, Mojtaba Jafari, Abdollah Kiyaei, Ramin Ravangard, Seyed Ali Hashemi, Khosro Keshavarz
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Health Economics Review
Subjects:
Online Access:https://doi.org/10.1186/s13561-025-00648-1
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author Zahra Goudazi
Mojtaba Jafari
Abdollah Kiyaei
Ramin Ravangard
Seyed Ali Hashemi
Khosro Keshavarz
author_facet Zahra Goudazi
Mojtaba Jafari
Abdollah Kiyaei
Ramin Ravangard
Seyed Ali Hashemi
Khosro Keshavarz
author_sort Zahra Goudazi
collection DOAJ
description Abstract Objective The costs of robot-assisted surgery are high compared to traditional surgeries, the main objective of this study is to investigate the cost-effectiveness of robotic total knee arthroplasty (rTKA) and manual total knee arthroplasty (mTKA) in Iran. Method The economic evaluation carried out from the perspective of the healthcare system used patients aged 64 years and older in Markov models. A cohort of 10,000 patients receiving either rTKA or mTKA was simulated using a Markov model. The time horizon of the study was lifetime and the model cycles were considered to be annual. From the literature and Iranian experts, transition probabilities, costs, and utility values were extracted. The incremental cost-effectiveness ratio (ICER) was also calculated. The evaluator was willing to pay ppp$ 16,153 for each quality-adjusted life year (QALY) gained. Sensitivity analyses were performed to test the robustness of the uncertainties of the model’s variables. Results A base case analysis showed the rTKA strategy to be more costly ($18,599) than the mTKA strategy ($16,804), with an associated greater effectiveness of 9.20 versus 9.05 QALYs. The value of the incremental cost-effectiveness ratio (ICER) of rTKA in contrast to mTKA stood at $12,037 per QALY with a follow-up duration of 16 years, which is within the bounds of the threshold value of $16,153 per QALY set in Iran. In the probabilistic sensitivity analysis, there was a 90% probability that rTKA would be found cost-effective in comparison to mTKA. Conclusion In conclusion, this study finds that rTKA may be cost-effective than traditional methods in the context of Iran, especially as its value comes to be appreciated.
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spelling doaj-art-c3525f41fce449f1a4435d5a6450384c2025-08-20T03:45:19ZengBMCHealth Economics Review2191-19912025-07-0115111010.1186/s13561-025-00648-1Cost-effectiveness analysis of robotic-arm assisted total knee arthroplasty (TKA) versus conventional TKA in Iranian populationZahra Goudazi0Mojtaba Jafari1Abdollah Kiyaei2Ramin Ravangard3Seyed Ali Hashemi4Khosro Keshavarz5Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical SciencesStudent Research Committee, School of Management and Medical Information Sciences, Shiraz University of Medical SciencesStudent Research Committee, School of Management and Medical Information Sciences, Shiraz University of Medical SciencesHealth Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical SciencesDepartment of Orthopedics, School of Medicine, Shiraz University of Medical SciencesHealth Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical SciencesAbstract Objective The costs of robot-assisted surgery are high compared to traditional surgeries, the main objective of this study is to investigate the cost-effectiveness of robotic total knee arthroplasty (rTKA) and manual total knee arthroplasty (mTKA) in Iran. Method The economic evaluation carried out from the perspective of the healthcare system used patients aged 64 years and older in Markov models. A cohort of 10,000 patients receiving either rTKA or mTKA was simulated using a Markov model. The time horizon of the study was lifetime and the model cycles were considered to be annual. From the literature and Iranian experts, transition probabilities, costs, and utility values were extracted. The incremental cost-effectiveness ratio (ICER) was also calculated. The evaluator was willing to pay ppp$ 16,153 for each quality-adjusted life year (QALY) gained. Sensitivity analyses were performed to test the robustness of the uncertainties of the model’s variables. Results A base case analysis showed the rTKA strategy to be more costly ($18,599) than the mTKA strategy ($16,804), with an associated greater effectiveness of 9.20 versus 9.05 QALYs. The value of the incremental cost-effectiveness ratio (ICER) of rTKA in contrast to mTKA stood at $12,037 per QALY with a follow-up duration of 16 years, which is within the bounds of the threshold value of $16,153 per QALY set in Iran. In the probabilistic sensitivity analysis, there was a 90% probability that rTKA would be found cost-effective in comparison to mTKA. Conclusion In conclusion, this study finds that rTKA may be cost-effective than traditional methods in the context of Iran, especially as its value comes to be appreciated.https://doi.org/10.1186/s13561-025-00648-1Cost-effectivenessConventional therapyArthroplastyRobot-arm assistedTotal knee arthroplasty
spellingShingle Zahra Goudazi
Mojtaba Jafari
Abdollah Kiyaei
Ramin Ravangard
Seyed Ali Hashemi
Khosro Keshavarz
Cost-effectiveness analysis of robotic-arm assisted total knee arthroplasty (TKA) versus conventional TKA in Iranian population
Health Economics Review
Cost-effectiveness
Conventional therapy
Arthroplasty
Robot-arm assisted
Total knee arthroplasty
title Cost-effectiveness analysis of robotic-arm assisted total knee arthroplasty (TKA) versus conventional TKA in Iranian population
title_full Cost-effectiveness analysis of robotic-arm assisted total knee arthroplasty (TKA) versus conventional TKA in Iranian population
title_fullStr Cost-effectiveness analysis of robotic-arm assisted total knee arthroplasty (TKA) versus conventional TKA in Iranian population
title_full_unstemmed Cost-effectiveness analysis of robotic-arm assisted total knee arthroplasty (TKA) versus conventional TKA in Iranian population
title_short Cost-effectiveness analysis of robotic-arm assisted total knee arthroplasty (TKA) versus conventional TKA in Iranian population
title_sort cost effectiveness analysis of robotic arm assisted total knee arthroplasty tka versus conventional tka in iranian population
topic Cost-effectiveness
Conventional therapy
Arthroplasty
Robot-arm assisted
Total knee arthroplasty
url https://doi.org/10.1186/s13561-025-00648-1
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