A cost-utility analysis of robotic arm-assisted total hip arthroplasty: using robotic data from the private sector and manual data from the National Health Service

N. D. Clement*, P. Gaston, D. F. Hamilton, A. Bell, P. Simpson, G. J. Macpherson, J. T. Patton

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose. The aim was to assess the cost-effectiveness of robotic arm-assisted total hip arthroplasty (rTHA) compared with manual total hip arthroplasty (mTHA) and to assess the influence of annual volume on the relative cost-effectiveness of rTHA. Methods. A database of both rTHA (n = 48 performed in a private centre) and mTHA (n = 512 performed in the National Health Service) was used. Patient demographics, preoperative Oxford hip score, forgotten joint score, EuroQol 5-dimensional 3-level (EQ-5D), and postoperative EQ-5D were recorded. Two models for incremental cost-effectiveness ratios using cost per quality-adjusted life year (QALY) for rTHA were calculated based on a unit performing 100 rTHAs per year: 10-year follow-up and a lifetime time horizon (remaining life expectancy of a 69-year-old patient). Results. When adjusting for confounding factors, rTHA was independently associated with a 0.091 () greater improvement in the EQ-5D compared to mTHA. This resulted in a 10-year time horizon cost per QALY for rTHA of £1,910 relative to mTHA, which increased to £2,349 per QALY when discounted (5%/year). When using the 10-year time horizon cost per QALY was approximately £3,000 for a centre undertaking 50 rTHAs per year and decreased to £1,000 for centre undertaking 200 rTHAs per year. Using a lifetime horizon, the incremental unadjusted cost per QALY gained was £980 and £1432 when discounted (5%/year) for rTHA compared with mTHA. Conclusions. Despite the increased cost associated with rTHA, it was a cost-effective intervention relative to mTHA due to the associated greater health-related quality of health gain, according to the EQ-5D outcome measure.
Original languageEnglish
Article number5962260
Number of pages8
JournalAdvances in Orthopedics
Volume2022
DOIs
Publication statusPublished - 27 Feb 2022

Keywords

  • hip arthroplasty
  • private sector
  • National Health Service

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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