![]() ![]() Healing rates and healing times are equivalent for both the EXOGEN 4000+ and surgery in the case of stable, well-aligned fractures.Īverage length of bed stay for surgery is 4.9 days (Hospital episode statistics online 2010/11).Īverage theatre time for non-union surgery is 3 hours.Īll initial non-union surgical management includes autologous iliac crest bone graft. The model assumed that no infection would occur in the EXOGEN arm.ĥ.6 In the sponsor's base case for non-union fracture, the key assumptions were cited as follows: ![]() In the surgery arm, patients were at risk of infection as a complication of surgery from the time of diagnosis of non-union, and also if they had further revision surgery after 6 months in the non-union state. In both arms, if healing had not occurred after 6 months in the non-union fracture health state, it was assumed that further surgery was needed. Patients in the EXOGEN arm had treatment with EXOGEN 4000+ from baseline, whereas patients in the control arm had surgery at baseline. All patients began in the 'non-union fracture' health state. The patient population included patients with fractures of the tibia initially treated by surgical insertion of an intramedullary nail.ĥ.4 For non-union fractures, the cost model evaluated the costs and consequences associated with the use of the EXOGEN 4000+ at diagnosis of non-union, followed by further surgery if the fracture did not heal within 6 months, compared with surgery at diagnosis, followed by repeat surgery if the fracture did not heal within 6 months.ĥ.5 The non-union model had 4 health states: 'non-union fracture', 'healed fracture', 'infection' and 'post infection'. Markov models with a 1‑year time horizon and monthly cycles were used to carry out each cost analysis. Full details of all cost evidence and modelling considered by the Committee are available in the assessment report overview.ĥ.3 Two cost models were submitted by the sponsor – 1 for non-union and 1 for delayed healing (both adapted from the model by Taylor et al. (2006) reported a similar analysis for the Ilizarov surgical procedure to treat complex non-union tibia or femur fractures.ĥ.2 The sponsor submitted a de novo cost analysis for EXOGEN. (2007) presented a non-comparative analysis of the cost of compression plate fixation and bone grafting to treat aseptic non-union long bone fractures, and Patil et al. The model developed for this study was adapted for use in the sponsor's submission. (2009) carried out a cost-effectiveness analysis on non-union tibial fractures treated by EXOGEN or by surgery (intramedullary nailing). 5.1 The sponsor identified 3 economic studies, all in UK settings.
0 Comments
Leave a Reply. |