Cost-effectiveness analysis of robotic-arm assisted total knee arthroplasty (TKA) versus conventional TKA in Iranian population.

IF 3.3 3区经济学 Q1 ECONOMICS

Health Economics Review Pub Date : 2025-07-04 DOI:10.1186/s13561-025-00648-1

Zahra Goudazi, Mojtaba Jafari, Abdollah Kiyaei, Ramin Ravangard, Seyed Ali Hashemi, Khosro Keshavarz

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Abstract

Objective: The costs of robot-assisted surgery are high compared to traditional surgeries, the main objective of this study is to investigate the cost-effectiveness of robotic total knee arthroplasty (rTKA) and manual total knee arthroplasty (mTKA) in Iran.

Method: The economic evaluation carried out from the perspective of the healthcare system used patients aged 64 years and older in Markov models. A cohort of 10,000 patients receiving either rTKA or mTKA was simulated using a Markov model. The time horizon of the study was lifetime and the model cycles were considered to be annual. From the literature and Iranian experts, transition probabilities, costs, and utility values were extracted. The incremental cost-effectiveness ratio (ICER) was also calculated. The evaluator was willing to pay ppp$ 16,153 for each quality-adjusted life year (QALY) gained. Sensitivity analyses were performed to test the robustness of the uncertainties of the model's variables.

Results: A base case analysis showed the rTKA strategy to be more costly ($18,599) than the mTKA strategy ($16,804), with an associated greater effectiveness of 9.20 versus 9.05 QALYs. The value of the incremental cost-effectiveness ratio (ICER) of rTKA in contrast to mTKA stood at $12,037 per QALY with a follow-up duration of 16 years, which is within the bounds of the threshold value of $16,153 per QALY set in Iran. In the probabilistic sensitivity analysis, there was a 90% probability that rTKA would be found cost-effective in comparison to mTKA.

Conclusion: In conclusion, this study finds that rTKA may be cost-effective than traditional methods in the context of Iran, especially as its value comes to be appreciated.

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伊朗人群机械臂辅助全膝关节置换术（TKA）与传统TKA的成本-效果分析。

目的：与传统手术相比，机器人辅助手术的成本较高，本研究的主要目的是研究伊朗机器人全膝关节置换术（rTKA）和人工全膝关节置换术（mTKA）的成本效益。方法：采用马尔可夫模型，从医疗卫生系统角度对64岁及以上患者进行经济评价。使用马尔可夫模型模拟接受rTKA或mTKA的10,000名患者的队列。研究的时间范围是终生的，模型周期被认为是年度的。从文献和伊朗专家中提取了转移概率、成本和效用值。计算了增量成本-效果比（ICER）。评估者愿意为每获得一个质量调整生命年（QALY）支付购买力平价16,153美元。进行敏感性分析以检验模型变量的不确定性的稳健性。结果：基本案例分析显示，rTKA策略比mTKA策略（16,804美元）更昂贵（18,599美元），相关的有效性为9.20 QALYs和9.05 QALYs。与mTKA相比，rTKA的增量成本效益比（ICER）的价值为每个QALY 12,037美元，随访时间为16年，这在伊朗设定的每个QALY 16,153美元的阈值范围内。在概率敏感性分析中，与mTKA相比，rTKA具有成本效益的概率为90%。结论：总而言之，本研究发现，在伊朗的背景下，rTKA可能比传统方法更具成本效益，特别是当其价值得到重视时。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Economics Review Multiple-

CiteScore

3.90

自引率

4.20%

发文量

审稿时长

13 weeks

期刊介绍： Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.