Back to Journals » ClinicoEconomics and Outcomes Research » Volume 8

Cost-effectiveness of minimally invasive sacroiliac joint fusion

Authors Cher D, Frasco M, Arnold R, Polly D

Received 12 August 2015

Accepted for publication 17 November 2015

Published 18 December 2015 Volume 2016:8 Pages 1—14

DOI https://doi.org/10.2147/CEOR.S94266

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Tracey-Lea Laba

Peer reviewer comments 3

Editor who approved publication: Professor Giorgio Lorenzo Colombo

Daniel J Cher,1 Melissa A Frasco,2 Renée JG Arnold,2,3 David W Polly4,5

1Clinical Affairs, SI-BONE, Inc., San Jose, CA, USA; 2Division of Health Economics and Outcomes Research, Quorum Consulting, Inc., San Francisco, CA, USA; 3Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 4Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA; 5Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA


Background: Sacroiliac joint (SIJ) disorders are common in patients with chronic lower back pain. Minimally invasive surgical options have been shown to be effective for the treatment of chronic SIJ dysfunction.
Objective: To determine the cost-effectiveness of minimally invasive SIJ fusion.
Methods: Data from two prospective, multicenter, clinical trials were used to inform a Markov process cost-utility model to evaluate cumulative 5-year health quality and costs after minimally invasive SIJ fusion using triangular titanium implants or non-surgical treatment. The analysis was performed from a third-party perspective. The model specifically incorporated variation in resource utilization observed in the randomized trial. Multiple one-way and probabilistic sensitivity analyses were performed.
Results: SIJ fusion was associated with a gain of approximately 0.74 quality-adjusted life years (QALYs) at a cost of US$13,313 per QALY gained. In multiple one-way sensitivity analyses all scenarios resulted in an incremental cost-effectiveness ratio (ICER) <$26,000/QALY. Probabilistic analyses showed a high degree of certainty that the maximum ICER for SIJ fusion was less than commonly selected thresholds for acceptability (mean ICER =$13,687, 95% confidence interval $5,162–$28,085). SIJ fusion provided potential cost savings per QALY gained compared to non-surgical treatment after a treatment horizon of greater than 13 years.
Conclusion: Compared to traditional non-surgical treatments, SIJ fusion is a cost-effective, and, in the long term, cost-saving strategy for the treatment of SIJ dysfunction due to degenerative sacroiliitis or SIJ disruption.

Keywords: cost-effectiveness analysis, degenerative sacroiliitis, minimally invasive surgery, sacroiliac joint arthrodesis, sacroiliac joint disruptions, sacroiliac joint dysfunction, spine surgery

Corrigendum for this paper has been published.

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Other articles by this author:

Work intensity in sacroiliac joint fusion and lumbar microdiscectomy

Frank C, Kondrashov D, Meyer SC, Dix G, Lorio M, Kovalsky D, Cher D

ClinicoEconomics and Outcomes Research 2016, 8:367-376

Published Date: 26 July 2016

Cost-effectiveness of minimally invasive sacroiliac joint fusion [Corrigendum]

Cher DJ, Frasco MA, Arnold RJG, Polly DW

ClinicoEconomics and Outcomes Research 2016, 8:305-306

Published Date: 27 June 2016

Ignoring the sacroiliac joint in chronic low back pain is costly

Polly DW, Cher D

ClinicoEconomics and Outcomes Research 2016, 8:23-31

Published Date: 21 January 2016

Implant survivorship analysis after minimally invasive sacroiliac joint fusion using the iFuse Implant System®

Cher DJ, Reckling WC, Capobianco RA

Medical Devices: Evidence and Research 2015, 8:485-492

Published Date: 23 November 2015

Sacroiliac joint pain: burden of disease

Cher D, Polly D, Berven S

Medical Devices: Evidence and Research 2014, 7:73-81

Published Date: 12 April 2014

Safety and 6-month effectiveness of minimally invasive sacroiliac joint fusion: a prospective study

Duhon BS, Cher DJ, Wine KD, Lockstadt H, Kovalsky D, Soo CL

Medical Devices: Evidence and Research 2013, 6:219-229

Published Date: 13 December 2013

Readers of this article also read:

Emerging and future therapies for hemophilia

Carr ME, Tortella BJ

Journal of Blood Medicine 2015, 6:245-255

Published Date: 3 September 2015

A new recombinant factor VIII: from genetics to clinical use

Santagostino E

Drug Design, Development and Therapy 2014, 8:2507-2515

Published Date: 12 December 2014

Methacrylic-based nanogels for the pH-sensitive delivery of 5-Fluorouracil in the colon

Ashwanikumar N, Kumar NA, Nair SA, Kumar GS

International Journal of Nanomedicine 2012, 7:5769-5779

Published Date: 15 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012