Forecasting the value of innovation in total knee arthroplasty care: A headroom approach
Abstract Purpose Total knee arthroplasty (TKA) is the standard treatment of end‐stage osteoarthritis. TKA is often used and, therefore, poses a healthcare and societal burden, which is likely to increase further. Headroom analyses evaluate a technology under development by making assumptions about i...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-10-01
|
| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jeo2.70096 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850052515678126080 |
|---|---|
| author | Thomas M. Otten Sabine E. Grimm Bram Ramaekers Alex Roth Pieter Emans Tim Boymans Maarten Janssen Ralph Jeuken Manuela A. Joore |
| author_facet | Thomas M. Otten Sabine E. Grimm Bram Ramaekers Alex Roth Pieter Emans Tim Boymans Maarten Janssen Ralph Jeuken Manuela A. Joore |
| author_sort | Thomas M. Otten |
| collection | DOAJ |
| description | Abstract Purpose Total knee arthroplasty (TKA) is the standard treatment of end‐stage osteoarthritis. TKA is often used and, therefore, poses a healthcare and societal burden, which is likely to increase further. Headroom analyses evaluate a technology under development by making assumptions about its effectiveness. This article applies a headroom approach to forecast the potential value of innovations that improve TKA‐related care in the Netherlands in terms of cost‐effectiveness and surgeries avoided. Methods A state‐transition model estimating lifetime direct health effects, healthcare‐ and societal costs and percentage of avoide d surgeries was developed. The model compared care as usual to five hypothetical interventions to calculate the headroom associated with (1) preventing the need for TKAs, (2) preventing the need for all TKA revisions, (3) postponing TKAs without quality‐of‐life loss, (4) preventing periprosthetic joint infections (PJIs) and (5) improving patient satisfaction. Results Preventing the need for all TKAs amounted to €43,076 of headroom. Preventing the need for TKA revisions amounted to €2276 (5.8% of surgeries avoided), postponing TKAs by 5 years amounted to €7634 (32.4% of surgeries avoided), preventing PJIs amounted to €1187 (1.4% of surgeries avoided) and improving patient satisfaction amounted to €16,622 (0% of surgeries avoided). The headroom of each hypothetical intervention was highest in younger populations (<50 years of age). Conclusion There is a headroom for improving TKA‐related care. Innovations to avoid or postpone TKA (i.e., joint‐preserving treatments) as well as those that improve patient satisfaction can be effective in maximizing the value for money and avoiding surgeries. Due to the decreasing average patient age, innovations to reduce revision rates and PJIs will become more valuable as these are most effective in younger patients. It is currently unclear how cost‐effectiveness considerations should be traded off against the prevention of surgery to reduce the increasing burden on the healthcare system. Level of Evidence Level III economic evaluation/decision‐analytic model. |
| format | Article |
| id | doaj-art-caa9c0db804a4ea684ef0ca61d438f08 |
| institution | DOAJ |
| issn | 2197-1153 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj-art-caa9c0db804a4ea684ef0ca61d438f082025-08-20T02:52:48ZengWileyJournal of Experimental Orthopaedics2197-11532024-10-01114n/an/a10.1002/jeo2.70096Forecasting the value of innovation in total knee arthroplasty care: A headroom approachThomas M. Otten0Sabine E. Grimm1Bram Ramaekers2Alex Roth3Pieter Emans4Tim Boymans5Maarten Janssen6Ralph Jeuken7Manuela A. Joore8Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA) Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Clinical Epidemiology and Medical Technology Assessment (KEMTA) Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Clinical Epidemiology and Medical Technology Assessment (KEMTA) Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Orthopaedic Surgery CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Orthopaedic Surgery CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Orthopaedic Surgery CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Orthopaedic Surgery CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Orthopaedic Surgery CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Clinical Epidemiology and Medical Technology Assessment (KEMTA) Maastricht University Medical Centre Maastricht The NetherlandsAbstract Purpose Total knee arthroplasty (TKA) is the standard treatment of end‐stage osteoarthritis. TKA is often used and, therefore, poses a healthcare and societal burden, which is likely to increase further. Headroom analyses evaluate a technology under development by making assumptions about its effectiveness. This article applies a headroom approach to forecast the potential value of innovations that improve TKA‐related care in the Netherlands in terms of cost‐effectiveness and surgeries avoided. Methods A state‐transition model estimating lifetime direct health effects, healthcare‐ and societal costs and percentage of avoide d surgeries was developed. The model compared care as usual to five hypothetical interventions to calculate the headroom associated with (1) preventing the need for TKAs, (2) preventing the need for all TKA revisions, (3) postponing TKAs without quality‐of‐life loss, (4) preventing periprosthetic joint infections (PJIs) and (5) improving patient satisfaction. Results Preventing the need for all TKAs amounted to €43,076 of headroom. Preventing the need for TKA revisions amounted to €2276 (5.8% of surgeries avoided), postponing TKAs by 5 years amounted to €7634 (32.4% of surgeries avoided), preventing PJIs amounted to €1187 (1.4% of surgeries avoided) and improving patient satisfaction amounted to €16,622 (0% of surgeries avoided). The headroom of each hypothetical intervention was highest in younger populations (<50 years of age). Conclusion There is a headroom for improving TKA‐related care. Innovations to avoid or postpone TKA (i.e., joint‐preserving treatments) as well as those that improve patient satisfaction can be effective in maximizing the value for money and avoiding surgeries. Due to the decreasing average patient age, innovations to reduce revision rates and PJIs will become more valuable as these are most effective in younger patients. It is currently unclear how cost‐effectiveness considerations should be traded off against the prevention of surgery to reduce the increasing burden on the healthcare system. Level of Evidence Level III economic evaluation/decision‐analytic model.https://doi.org/10.1002/jeo2.70096cost savingeconomic advantagehealth technology assessmentknee arthroplastyosteoarthritis |
| spellingShingle | Thomas M. Otten Sabine E. Grimm Bram Ramaekers Alex Roth Pieter Emans Tim Boymans Maarten Janssen Ralph Jeuken Manuela A. Joore Forecasting the value of innovation in total knee arthroplasty care: A headroom approach Journal of Experimental Orthopaedics cost saving economic advantage health technology assessment knee arthroplasty osteoarthritis |
| title | Forecasting the value of innovation in total knee arthroplasty care: A headroom approach |
| title_full | Forecasting the value of innovation in total knee arthroplasty care: A headroom approach |
| title_fullStr | Forecasting the value of innovation in total knee arthroplasty care: A headroom approach |
| title_full_unstemmed | Forecasting the value of innovation in total knee arthroplasty care: A headroom approach |
| title_short | Forecasting the value of innovation in total knee arthroplasty care: A headroom approach |
| title_sort | forecasting the value of innovation in total knee arthroplasty care a headroom approach |
| topic | cost saving economic advantage health technology assessment knee arthroplasty osteoarthritis |
| url | https://doi.org/10.1002/jeo2.70096 |
| work_keys_str_mv | AT thomasmotten forecastingthevalueofinnovationintotalkneearthroplastycareaheadroomapproach AT sabineegrimm forecastingthevalueofinnovationintotalkneearthroplastycareaheadroomapproach AT bramramaekers forecastingthevalueofinnovationintotalkneearthroplastycareaheadroomapproach AT alexroth forecastingthevalueofinnovationintotalkneearthroplastycareaheadroomapproach AT pieteremans forecastingthevalueofinnovationintotalkneearthroplastycareaheadroomapproach AT timboymans forecastingthevalueofinnovationintotalkneearthroplastycareaheadroomapproach AT maartenjanssen forecastingthevalueofinnovationintotalkneearthroplastycareaheadroomapproach AT ralphjeuken forecastingthevalueofinnovationintotalkneearthroplastycareaheadroomapproach AT manuelaajoore forecastingthevalueofinnovationintotalkneearthroplastycareaheadroomapproach |