i3 Innovus, Stockholm, Sweden.
Osteoporos Int. 2010 Sep;21(9):1599-608. doi: 10.1007/s00198-009-1096-6. Epub 2009 Nov 19.
Balloon kyphoplasty (BKP) is a procedure used to treat vertebral compression fractures (VCFs). We developed a cost-effectiveness model to evaluate BKP in United Kingsdom patients with hospitalised VCFs and estimated the cost-effectiveness of BKP compared to non-surgical management. The results indicate that BKP provides a cost-effective alternative for treating these patients.
VCFs of osteoporotic patients are associated with chronic pain, a reduction in health-related quality of life (QoL) and high healthcare costs. BKP is a minimally invasive procedure that has resulted in pain relief, vertebral body height-restoration, decreased kyphosis and improved physical functioning in patients with symptomatic VCFs. BKP was shown to improve health-related QoL in a 12-month interim analysis of a randomised phase-III trial.
The objectives of this study were to develop a Markov cost-effectiveness model to evaluate BKP in patients with painful hospitalised VCFs and to estimate the cost-effectiveness of BKP compared with non-surgical management in a UK setting. It was assumed that QoL-benefits found at 12 months linearly approached zero during another 2 years, and that patients receiving BKP warranted six fewer hospital bed days compared with patients given non-surgical management.
The procedure was associated with quality-adjusted life-years (QALY)-gains of 0.17 and cost/QALY-gains at 8,800 pound sterling. The results were sensitive to assumptions about avoided length of hospital-stay and persistence of kyphoplasty-related QoL-benefits.
In conclusion, the results indicate that BKP provides a cost-effective alternative for treating patients with hospitalised VCFs in a UK-setting.
球囊椎体后凸成形术（BKP）是一种用于治疗椎体压缩性骨折（VCF）的方法。我们开发了一种成本效益模型，以评估英国住院 VCF 患者的 BKP，并估计 BKP 与非手术治疗相比的成本效益。结果表明，BKP 为治疗这些患者提供了一种具有成本效益的替代方案。
骨质疏松症患者的 VCF 与慢性疼痛、健康相关生活质量（QoL）下降和高医疗保健成本有关。BKP 是一种微创程序，可缓解疼痛、恢复椎体高度、减少后凸畸形并改善有症状 VCF 患者的身体功能。BKP 在一项随机 III 期试验的 12 个月中期分析中显示可改善健康相关 QoL。
本研究的目的是开发一种马尔可夫成本效益模型，以评估 BKP 在患有疼痛性住院 VCF 的患者中的应用，并在英国环境中估计 BKP 与非手术治疗相比的成本效益。假设在另外 2 年内，12 个月时发现的 QoL 益处呈线性接近零，并且与接受非手术治疗的患者相比，接受 BKP 治疗的患者需要减少 6 天的住院天数。
该手术与 0.17 个质量调整生命年（QALY）的收益和 8800 英镑的成本/QALY 收益相关。结果对避免住院时间和球囊椎体后凸成形术相关 QoL 益处的持久性的假设敏感。
总之，结果表明，BKP 为治疗英国住院 VCF 患者提供了一种具有成本效益的替代方案。
