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Minimally Invasive Sacroiliac Joint Fusion with Triangular Titanium Implants: Cost-Utility Analysis from NHS Perspective

Author

Listed:
  • Deirdre B. Blissett

    (MedTech Economics Ltd.)

  • Rob S. Blissett

    (MedTech Economics Ltd.)

  • Matthew P. Newton Ede

    (The Royal Orthopaedic Hospital
    Precision Spine)

  • Philip M. Stott

    (Brighton and Sussex University Hospitals NHS Trust)

  • Daniel J. Cher

    (SI-BONE, Inc.)

  • W. Carlton Reckling

    (SI-BONE, Inc.)

Abstract

Objective The aim was to identify the cost-effectiveness of minimally invasive sacroiliac joint fusion (MI SIJF) surgery with titanium triangular implants for patients with sacroiliac joint (SIJ) pain who have failed conservative management, compared to non-surgical management (NSM) from a National Health Service (NHS) England perspective. Methods Over a time horizon of 5 years, a cohort state transition model compared the costs and outcomes of treating patients with MI SIJF to those of traditional NSM treatment pathways. The NSM arm included two treatments: grouped physical therapy and corticosteroid injections (PTSI) or radiofrequency ablation (RFA). Three different strategies were considered: (1) a stepped pathway, (2) patients split between PTSI and RFA, and (3) RFA only. The outcome measure was incremental cost-effectiveness ratio (ICER), reported in 2018 British pounds per quality-adjusted life year (QALY) gained. One-way and probabilistic sensitivity analyses were used to test the robustness of the model results. Results Patients undergoing MI SIJF accrued total procedure-related and pain-management costs of £8358, while NSM treatment strategy 1 had total costs of £6880. The MI SIJF cohort had 2.98 QALYs compared to strategy 1 with 2.30 QALYs. This resulted in an ICER for MI SIJF versus strategy 1 of £2164/QALY gained. Strategy 2 of the NSM arm had lower costs than strategy 1 (£6564) and 2.26 QALYs, and this resulted in an ICER of £2468/QALY gained for MI SIJF. Strategy 3 of the NSM arm had lower costs than strategy 1 (£6580), and this resulted in 2.28 QALYs and an ICER of £2518/QALY gained for MI SIJF. Probabilistic sensitivity analysis shows that at a threshold of £20,000/QALY gained, MI SIJF has a probability of being cost-effective versus NSM strategies of 96%, 97%, and 91% for strategies 1, 2, and 3, respectively. Conclusion MI SIJF appears to be cost-effective over a 5-year time horizon when compared to traditional NSM pathways in an NHS context.

Suggested Citation

  • Deirdre B. Blissett & Rob S. Blissett & Matthew P. Newton Ede & Philip M. Stott & Daniel J. Cher & W. Carlton Reckling, 2021. "Minimally Invasive Sacroiliac Joint Fusion with Triangular Titanium Implants: Cost-Utility Analysis from NHS Perspective," PharmacoEconomics - Open, Springer, vol. 5(2), pages 197-209, June.
    • Handle: RePEc:spr:pharmo:v:5:y:2021:i:2:d:10.1007_s41669-020-00236-5
    DOI: 10.1007/s41669-020-00236-5
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    References listed on IDEAS

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    1. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
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    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Journal round-up: PharmacoEconomics – Open 5(2)
      by Rita Faria in The Academic Health Economists' Blog on 2021-07-26 06:00:01

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