Portal de investigação
Robotic-Assisted vs Nonrobotic-Assisted Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Cost-Utility Analysis
Autores da FMUP
Participantes de fora da FMUP
- Garcia, D
- Akinduro, OO
- De Biase, G
- Jerreld, DJ
- Dholakia, R
- Borah, B
- Nottmeier, E
- Deen, HG
- Fox, WC
- Bydon, M
- Chen, S
- Quinones Hinojosa, A
- Abode Iyamah, K
Unidades de investigação
Abstract
BACKGROUND:Management of degenerative disease of the spine has evolved to favor minimally invasive techniques, including nonrobotic-assisted and robotic-assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Value-based spending is being increasingly implemented to control rising costs in the US healthcare system. With an aging population, it is fundamental to understand which procedure(s) may be most cost-effective.OBJECTIVE:To compare robotic and nonrobotic MIS-TLIF through a cost-utility analysis.METHODS:We considered direct medical costs related to surgical intervention and to the hospital stay, as well as 1-yr utilities. We estimated costs by assessing all cases involving adults undergoing robotic surgery at a single institution and an equal number of patients undergoing nonrobotic surgery, matched by demographic and clinical characteristics. We adopted a willingness to pay of $50 000/quality-adjusted life year (QALY). Uncertainty was addressed by deterministic and probabilistic sensitivity analyses.RESULTS:Costs were estimated based on a total of 76 patients, including 38 undergoing robot-assisted and 38 matched patients undergoing nonrobot MIS-TLIF. Using point estimates, robotic surgery was projected to cost $21 546.80 and to be associated with 0.68 QALY, and nonrobotic surgery was projected to cost $22 398.98 and to be associated with 0.67 QALY. Robotic surgery was found to be more cost-effective strategy, with cost-effectiveness being sensitive operating room/materials and room costs. Probabilistic sensitivity analysis identified robotic surgery as cost-effective in 63% of simulations.CONCLUSION:Our results suggest that at a willingness to pay of $50 000/QALY, robotic-assisted MIS-TLIF was cost-effective in 63% of simulations. Cost-effectiveness depends on operating room and room (admission) costs, with potentially different results under distinct neurosurgical practices.
Dados da publicação
- ISSN/ISSNe:
- 1524-4040, 0148-396X
- Tipo:
- Article
- Páginas:
- 192-198
- Link para outro recurso:
- www.scopus.com
Neurosurgery Lippincott Williams and Wilkins Ltd.
Citações Recebidas na Web of Science: 20
Citações Recebidas na Scopus: 33
Documentos
- Não há documentos
Filiações
Keywords
- Minimally invasive; Transforaminal lumbar interbody fusion; Health economic model; Costs; Spinal; Spine surgery
Proyectos asociados
Seroprevalence of SARS-CoV-2 and assessment of epidemiologic determinants in Portuguese municipal workers
Investigador Principal: Bernardo Manuel De Sousa Pinto
Estudo Clínico Académico (SARS-CoV-2) . 2021
Citar a publicação
Garcia D,Akinduro OO,De Biase G,Sousa B,Jerreld DJ,Dholakia R,Borah B,Nottmeier E,Deen HG,Fox WC,Bydon M,Chen S,Quinones A,Abode K. Robotic-Assisted vs Nonrobotic-Assisted Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Cost-Utility Analysis. Neurosurgery. 2022. 90. (2):p. 192-198. IF:4,800. (1).
