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Cost effectiveness of treatment with percutaneous Kirschner wires versus volar locking plate for adult patients with a dorsally displaced fracture of the distal radius
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Tubeuf, S., Yu, G., Achten, J., Parsons, Nicholas R., Rangan, A., Lamb, S. E. (Sallie E.) and Costa, Matthew L. (2015) Cost effectiveness of treatment with percutaneous Kirschner wires versus volar locking plate for adult patients with a dorsally displaced fracture of the distal radius. Bone & Joint Journal, 97-B (8). pp. 1082-1089. doi:10.1302/0301-620X.97B8.35234 ISSN 2049-4394.
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Official URL: http://dx.doi.org/10.1302/0301-620X.97B8.35234
Abstract
We present an economic evaluation using data from the Distal Radius Acute Fracture Fixation Trial (DRAFFT) to compare the relative cost effectiveness of percutaneous Kirschner wire (K-wire) fixation and volar locking-plate fixation for patients with dorsally-displaced fractures of the distal radius. The cost effectiveness analysis (cost per quality-adjusted life year; QALY) was derived from a multi-centre, two-arm, parallel group, assessor-blind, randomised controlled trial which took place in 18 trauma centres in the United Kingdom. Data from 460 patients were available for analysis, which includes both a National Health Service cost perspective including costs of surgery, implants and healthcare resource use over a 12-month period after surgery, and a societal perspective, which includes the cost of time off work and the need for additional private care. There was only a small difference in QALYs gained for patients treated with locking-plate fixation over those treated with K-wires. At a mean additional cost of £714 (95% confidence interval 588 to 865) per patient, locking-plate fixation presented an incremental cost effectiveness ratio (ICER) of £89 322 per QALY within the first 12 months of treatment. Sensitivity analyses were undertaken to assess the ICER of locking-plate fixation compared with K-wires. These were greater than £30 000. Compared with locking-plate fixation, K-wire fixation is a 'cost saving' intervention, with similar health benefits. © 2015 The British Editorial Society of Bone & Joint Surgery.
Item Type: | Journal Article | ||||
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Subjects: | R Medicine > R Medicine (General) | ||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Bone & Joint Journal | ||||
Publisher: | British Editorial Society of Bone and Joint Surgery | ||||
ISSN: | 2049-4394 | ||||
Official Date: | 1 August 2015 | ||||
Dates: |
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Volume: | 97-B | ||||
Number: | 8 | ||||
Page Range: | pp. 1082-1089 | ||||
DOI: | 10.1302/0301-620X.97B8.35234 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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