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  • Cost-Effectiveness of Transtibial Bone-Anchored Prostheses Using Osseointegrated Fixation: From Challenges to Preliminary Data

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    Frossard492202-Accepted.pdf (2.592Mb)
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    Accepted Manuscript (AM)
    Author(s)
    Frossard, Laurent
    Ferrada, Luciann
    Quincey, Tanya
    Berg, Debra
    Griffith University Author(s)
    Frossard, Laurent
    Year published
    2021
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    Abstract
    Introduction This initial cost-effectiveness evaluation compared the provision of transtibial bone-anchored prostheses (TTA-BAPs) with socket-suspended prostheses (TTA-SSPs) over a 6-year time horizon from a governmental prosthetic care perspective. The purposes were to present ways we dealt with barriers encountered during the cost-effectiveness analysis. The objectives were to detail the extraction of baseline and incremental costs and utilities required to provide preliminary incremental cost-effectiveness ratios (ICERs) per quality-adjusted life-year (QALY). Materials and Methods This retrospective case-series study ...
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    Introduction This initial cost-effectiveness evaluation compared the provision of transtibial bone-anchored prostheses (TTA-BAPs) with socket-suspended prostheses (TTA-SSPs) over a 6-year time horizon from a governmental prosthetic care perspective. The purposes were to present ways we dealt with barriers encountered during the cost-effectiveness analysis. The objectives were to detail the extraction of baseline and incremental costs and utilities required to provide preliminary incremental cost-effectiveness ratios (ICERs) per quality-adjusted life-year (QALY). Materials and Methods This retrospective case-series study involved six participants fitted consecutively with TTA-SSP and TTA-BAP. Total costs combined actual and typical costs extracted from financial records and a schedule of allowable expenses, respectively. Baseline utilities were extracted from the literature, whereas incremental utilities were assumed. Results ICERs ranged between −$25,065 and $41,929 per QALY. Indicative ICER was approximately $11,400 per QALY. Provision of TTA-BAP was cost-effective and cost saving for 83% and 33% of cases, respectively. Discussion Educated choices were required to overcome unavailability of individual costs (e.g., creation of schedule of allowable expenses, blending of actual and typical costs) and utilities (e.g., extraction of baseline from literature, assumptions for incremental gain). Indicative ICER might lead to adoption of TTA-BAP, at least from an Australian governmental prosthetic care perspective.
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    Journal Title
    Journal of Prosthetics and Orthotics
    Volume
    33
    Issue
    3
    DOI
    https://doi.org/10.1097/jpo.0000000000000372
    Copyright Statement
    © 2021 by the American Academy of Orthotists and Prosthetists. This is a non-final version of an article published in final form in Journal of Prosthetics and Orthotics, 2021, 33 (3), pp. 184-195. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal link for access to the definitive, published version.
    Subject
    Clinical sciences
    Publication URI
    http://hdl.handle.net/10072/405223
    Collection
    • Journal articles

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