Delaying Total Hip Replacement surgery (THR) in people with osteoarthritis (OA) as a way to cut costs is ineffective and denies patients the benefits of an active and healthy life. Moreover, young adults do not benefit from postponing the treatment to avoid revision surgery in later life as the majority of younger people will never have to undergo revision surgery with current technology.
Eucomed, the European Medical Technology Industry Association, welcomes the findings of research undertaken by the European Health Technology Institute for Socio-Economic Research (EHTI) into the budget implication for the Italian National Health Service of early access versus delayed THR. The findings have been published in Value in Health and demonstrated the cost-effectiveness of early total hip replacement.
Ruben Mujica-Mota, the lead researcher and Senior Lecturer Health Economics at the University of Exeter commented on the study: “This research clearly suggests that the cost savings to national health systems in Europe brought about by delaying THR may not justify the large quality of life losses to patients.”
The study “Cost-Effectiveness Analysis of Early versus Late Total Hip Replacement in Italy” is the first study evaluating the cost-effectiveness of delaying Total Hip Replacement. Three options for treating functionally independent patients with severe osteoarthritis were assessed:
- Immediate primary THR;
- Non-surgical therapy followed by primary THR upon disease progression to a functionally dependent state;
- Drug treatment.
“The outcome of the model indicates that a healthcare strategy delaying intervention of THR in patients with severe osteoarthritis has limited value in reducing the total cost of treatment. On the contrary, a strategy of not postponing total hip replacement surgery provides a significant benefit to patients”, said Yves Verboven, Executive Director EHTI.
The research is based on scientific data assessing the impact of early access to medical technology for a well defined patients group on these patients’ ability to lead an active and healthy life, while also investigating its impact on healthcare budgets.
“It is encouraging to see that for patients with osteoarthritis early access to current total hip replacements can be offered cost-effectively. We look forward to the results of on-going research into the socio-economic benefit and implications on retirement age of total hip replacements,” Renaat Vermeulen, Industry representative on the EHTI Board commented on the findings.
Osteoarthritis is a condition whereby more cartilage in the joints is broken down than can be produced by the body. Parallel to this, the level of synovium, the fluid within the bones, decreases. Synovium is essential to ensure a smooth rotation of the joints and serves as a shock absorber. Friction between joints due to a disappearing cartilage or decreased levels of Synovium can be very painful.