Purpose

The objective of this study was to estimate the cost effectiveness of Arthroscopic Matrix-based Meniscus Repair (AMMR) in Poland, German, UK and Switzerland in the both the National Health Service (NHS) and from the perspective of private patients (PP).

Methods and Materials

A Markov health-state model was developed to evaluate the cost-utility analysis of AMMR compared to meniscectomy (ME) for patients with complex meniscus tear, using a 10-years horizon, modelling a cohort of 1000 patients. Initial probabilities and clinical course were simulated based on previously published data. A literature review identified different clinical outcome probabilities and health-related utility scores associated with each health state. Cost effectiveness was presented as an indicator of Incremental Cost-Utility Ratio (ICUR).

Results

In the 10 -year horizon, AMMR was associated with an increase in discounted quality-adjusted life-years (QALYs) to 7 778.25 as compared to 7 454.33 for ME. In both perspectives, (PNHS and PP) the ICUR cost is smaller than willingness to pay (WTP-125,955 PLN) parameter (PNHS-ICUR = 34,212.92 and PP-ICUR = 29,897.36) for Poland.

For Germany AMMR was associated with an increase in discounted QALYs to 7,858.64 as compared to 7,529.43 for ME. In both perspectives, (PNHS and PP) the ICUR cost is smaller than WTP (40,000 EUR) parameter (GNHS-ICUR = 10,661.75 and PP-ICUR = 22,924.05)

For UK, AMMR was associated with an increase in discounted QALYs to 7,844.55 as compared to 7,516.18 for ME. In both perspectives, (PNHS and PP) the ICUR cost is smaller than WTP (30,000 GBP) parameter (UKNHS-ICUR = 2,154.29 and PP-ICUR = 3,811.14).

For Switzerland, AMMR was associated with an increase in discounted QALYs to 8,073.35 as compared to 7,730.66 for ME. PP-ICUR (16,122.94) cost is smaller than WTP (100,000 CHF) parameter.

Conclusion

Despite the increase in costs, the procedure is cost-effective with standard thresholds used in all assessed countries for both analyzed perspectives