Table 2.
Results of analysis for base case
| Cost scenario | Avg. cost | Avg. QALYs gained | Avg. cost difference | Avg. difference in QALYs gained | Cost-effectiveness ratio | Incremental cost-effectiveness ratio | |
|---|---|---|---|---|---|---|---|
| A |
TKA without delay |
$17,840 |
12.18 |
$1,667 |
0.61 |
$1,464/QALY |
$2,723/QALY |
| Delayed TKA with Nonop Bridge |
$21,230 |
11.76 |
$3,398 |
0.19 |
$1,806/QALY |
$17,880/QALY* |
|
| Delay + No Bridge |
$16,170 |
11.57 |
- |
- |
$1,398/QALY |
- |
|
| B |
TKA without delay |
$59,640 |
12.18 |
- |
0.61 |
$4,897/QALY |
|
| Delayed TKA with Nonop Bridge |
$78,541 |
11.76 |
$18,900 |
0.19 |
$6,679/QALY |
DOMINATED** |
|
| Delay + No Bridge | $73,477 | 11.57 | $13,836 | - | $6,351/QALY | DOMINATED** |
Cost scenario A = Direct costs only, Cost scenario B = Indirect costs included
*Waiting with a non-operative bridge resulted in a lower number of average quality-adjusted life-years gained while also at a higher average cost to the payer and is, therefore, “DOMINATED” by the TKA without delay strategy for the treatment of end-stage knee osteoarthritis in the base case. It is considered cost effective compared to delayed TKA with no treatment bridge.
**When indirect costs are considered, TKA without delay is both less costly and more effective than the other two strategies and is therefore a dominant treatment strategy.