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首页> 外文期刊>Current medical research and opinion >Is dibotermin alfa a cost-effective substitute for autologous iliac crest bone graft in single level lumbar interbody spine fusion?
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Is dibotermin alfa a cost-effective substitute for autologous iliac crest bone graft in single level lumbar interbody spine fusion?

机译：Dibotermin Alfa是一种成本有效的单级腰椎骨椎间移植物的成本效益替代单级腰椎脊柱融合吗？

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Objectives:To evaluate the cost-effectiveness of dibotermin alfa compared with autologous iliac crest bone graft (ICBG) for patients undergoing single level lumbar interbody spinal fusion in a UK hospital setting.Methods:An individual patient data (IPD) meta-analysis of six randomized controlled clinical trials and two single arm trials compared dibotermin alfa on an absorbable collagen implantation matrix (ACIM) (n=456) and ICBG (n=244) on resource use, re-operation rates, and SF-6D (Short form 6-dimension) health utility (total N=700). Failure-related second surgery, operating time, post-operative hospital stay, and quality-adjusted life years (QALYs) derived from the IPD meta-analysis were included as inputs in an economic evaluation undertaken to assess the cost-effectiveness of dibotermin alfa/ACIM versus ICBG for patients undergoing single level lumbar interbody spinal fusion. A four year time horizon and the United Kingdom (UK) National Health Service (NHS) and Personal Social Services (PSS) perspective was adopted in the base case, with sensitivity analyses performed to gauge parameter uncertainty.Results:In the base case analysis, patients treated using dibotermin alfa/ACIM (12mg pack) accrued 0.055 incremental QALYs at an incremental cost of 737, compared with patients treated with ICBG. This resulted in an incremental cost-effectiveness ratio (ICER) of 13,523 pound, indicating that at a willingness-to-pay threshold of 20,000 pound, dibotermin alfa/ACIM is a cost-effective intervention relative to ICBG from the NHS and PSS perspective.Conclusions:In a UK hospital setting, dibotermin alfa/ACIM is a cost-effective substitute for ICBG for patients who require lumbar interbody arthrodesis.
机译：目的：评估Dibotermin Alfa的成本效益与自体髂嵴骨移植（ICBG）进行英国医院设置的单一腰椎间脊柱融合的患者。方法：一个个体患者数据（IPD）Meta分析六个随机对照临床试验和两个单臂试验在可吸收的胶原植入基质（ACIM）（N = 456）和ICBG（n = 456）上比较了资源使用，重新运行率和SF-6D（短表格6 -dimension）健康实用程序（总N = 700）。与IPD元分析的失败相关的第二次手术，操作时间，术后住院住宿和质量调整的生命年（QALYS）被列为评估Dibotermin Alfa的成本效益/的经济评估中的投入ACIM与ICBG为接受单级腰椎椎间脊柱融合的患者。在基本情况下采用了四年时间和英国（英国）国家卫生服务（NHS）和个人社会服务（PSS）观点，具有仪表参数不确定性的敏感性分析。结果：在基本案例分析中，与用ICBG治疗的患者相比，使用Dibotermin Alfa / Acim（12mg包装）使用Dibotermin Alfa / Acim（12mg包装）的增量成本累积为0.055个增量qalys，其增量成本为737。这导致了13,523磅的增量成本效率（ICER），表明，在20,000磅的意愿阈值下，Dibotermin Alfa / Acim是来自NHS和PSS视角的相对于ICBG具有成本效益的干预。结论：在英国医院环境中，Dibotermin Alfa / Acim是一种成本效益的ICBG替代患者，用于患者腰部间关节术。

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