Cost-effectiveness modeling showed that reserving TKR for more seriously affected patients may make it more economically attractive. The QALYs gained from TKR was about 11 but as the number of QALYs increased, so did the relative lifetime cost, with increasing incremental cost-effectiveness ratios (ICERs) as SF-12 PCS rose. ICERs were around $143,000, $160,000, $217,000, $385,000, and $1,175,000 considering patients with SF-12 PCS of less than 30, 35, 40, 45, and 50, respectively.
“The more lenient the eligibility criteria are, the higher the effectiveness, but also the higher the costs,” Dr. Ferket said. “The most cost-effective scenarios are actually more restrictive that what is currently seen in current practice in the U.S.”
Dr. Pinedo-Villanueva and Dr. Ferket reported having no financial disclosures.