Cost-utility analysis of vertebroplasty versus thoracolumbosacral orthosis in the treatment of traumatic vertebral fractures
Auteur(s) : YAKHELEF [N] , AUDIBERT [M] , PEIRERA [B] , MONS [A] , CHABERT [E]
Abstract / Résumé : In this research we compared the cost-utility of vertebroplasty versus bracing for treatment of post-traumatic fractures. Cost and health outcomes were assessed from a prospective, randomized, non-blinded, single-center study that was carried out between May 2010 and November 2011 at the University Hospital of Clermont-Ferrand, France. The study included 99 patients, aged from 18 years to 70 years, suffering from acute non-osteoporotic vertebral fracture. We compared the costs and Quality-Adjusted Life Years (QALY) and assessed the Incremental Cost-Effectiveness Ratio for the two arm groups. Health insurance and patient perspectives were considered. From the health insurance perspective, total cost was €7,267 for the brace group whereas it was €7,365 for the vertebroplasty group (mean difference €75.3; p <0.9). From the patient perspective, total cost was €5,303 for the brace group and €3,435 for the vertebroplasty group (mean difference €-1,900.7; p<0.02). Differences between groups in QALYs were non-significant: 0.01 (95% CI -0.01 to 0.04; p=0.5). The Incremental Cost-Effectiveness Ratio of vertebroplasty was €-12,200 per QALY from the health insurance perspective and €-159,200 per QALY from the patient perspective. While the QALY values do not differ between the two groups, the vertebroplasty technique resulted in significantly lower costs from the patient perspective in France. From the health insurance perspective, we were unable to conclude if vertebroplasty was more cost-effective than bracing.