Cost-utility analysis and net monetary benefit of Platelet Rich Plasma (PRP), intra-articular injections in compared to Plasma Rich in Growth Factors (PRGF), Hyaluronic Acid (HA) and ozone in knee osteoarthritis in Iran

BMC Musculoskeletal Disorders

Research

Seyed Ahmad Raeissadat¹  Najmeh Moradi²  Mohammad Rahimi³  Seyed Mansoor Rayegani⁴ 

[1]Clinical Research Development Center, Shahid Modarres Hospital, Physical Medicine and Rehabilitation Research Center and Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran

[2]Physical Medicine and Rehabilitation Research Center and Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

[3]Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran

[4]Physical Medicine and Rehabilitation Research Center and Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

[5]Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

关键词: Knee Osteoarthritis;    Cost-utility analysis;    QALY;    Intra-Articular Injections;    Hyaluronic Acid;    Platelet-Rich Plasma;    Ozone Therapy;    Platelet-Rich Growth Factor;   

DOI  :  10.1186/s12891-022-06114-x

 received in 2022-09-20, accepted in 2022-12-23,  发布年份 2022

来源: Springer

【 摘 要 】

PurposeTo evaluate the cost-effectiveness of Platelet Rich Plasma (PRP), Plasma Rich in Growth Factors (PRGF), Hyaluronic Acid (HA) and ozone as effective treatment approaches in knee osteoarthritis management from Iran Health care perspective.MethodsA decision tree model was conducted to assess the cost-effectiveness of four common intra-articular treatment approaches in patients with mild and moderate knee osteoarthritis. The data on clinical effectiveness was obtained from a randomized controlled trial (RCT) conducted in Iran and used to estimate utility values. The direct medical costs were estimated according to tariffs for public medical centers and hospitals, approved by the Iran Ministry of Health and Medical Education in 2021. The incremental cost-effectiveness ratio (ICER) and the net monetary benefit (NMB) were used to evaluate the cost-utility analysis. Deterministic and probabilistic sensitivity analyses are performed to investigate the robustness of the results and account for the different sources of uncertainty.ResultsIn this study, HA intra-articular injection-related costs ($581.67/patient) were defined as the highest cost, followed by PRGF ($328.10/patient), PRP (318.58/patient), and Ozone (103.20/patient). According to the utility value, PRP and PRGF (0.68) have the same and the most utility among Intra-articular injections in knee osteoarthritis management. However, the PRP injection method was identified as the most cost-effective intervention due to its high NMB and ICER estimates. Based on the Monte Carlo Simulation, PR intervention, compared to other ones, was introduced as the dominant strategy regarding knee OA management, with a WTP of $10,000 for 100% of cases.ConclusionThe study result demonstrated that intra-articular injection of PRP, compare to other injections, is a cost-effective treatment option for patients with mild and moderate knee osteoarthritis. In addition, intra-articular injection of PRP was identified as the best injection, with the highest level of net monetary benefit, for knee OA management.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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Fig. 1