Cost-utility analysis of total knee arthroplasty alone and in comparison with post-surgical rehabilitation and conservative treatment in the Republic of Kazakhstan

Serikova-Esengeldina D. Glushkova N. Abdushukurova G. Mussakhanova A. Mukhamejanova A. Khismetova Z. Bokov D. Ivankov A. Goremykina M. Semenova Y.
December 2022 BioMed Central Ltd

Cost Effectiveness and Resource Allocation
2022 #20 Issue 1

Background: Despite ample international knowledge on cost-effectiveness of total knee arthroplasty (TKA), it has never been a subject of investigation in Kazakhstan or other post-Soviet economies. Our study aimed to carry-out the cost-utility analysis of TKA alone and in comparison with post-surgical rehabilitation and conservative treatment at health care facilities of Kazakhstan. Methods: Two hundred and forty four patients with knee osteoarthritis (KOA) who underwent TKA in orthopedic departments of Almaty, Nur-Sultan and Semey hospitals between January 1, 2019 and September 30, 2019 were followed-up for 12 months. The health-related quality of life was measured by the EQ-5D utility and Western Ontario and McMaster Universities Osteoarthritis Index was used to measure the patients’ health status. The costs were estimated from the view of health care provider. We calculated the cost per QALY, the Cost-Utility Ratio and the Incremental Cost-Effectiveness Ratio. Results: At the time of 12-month follow-up patients who received TKA alone or with the course of rehabilitation showed benefit over patients from the group of conservative treatment in terms of overall health status. Mean QALY gained at 12 months constituted 1.66 for the group that received TKA with rehabilitation, 1.48 for the group that received TKA alone and 0.24 for the group that received conservative treatment. Mean cost per QALY gained was USD 30 795.75 for KOA patients under conservative treatment, USD 6 323.69 for KOA patients subjected to TKA and USD 2 670.32 for KOA patients with rehabilitation course after TKA. Conclusion: Both TKA and TKA with rehabilitation could be considered as highly cost-effective interventions. The data obtained could be of interest for policy makers, medical professionals and KOA patients.

Cost analysis , Cost-utility ratio , Incremental cost-effectiveness ratio , QALY , Total knee arthroplasty

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Department of Public Health, Semey Medical University, Semey, Kazakhstan
Faculty of Medicine and Healthcare, Al-Farabi Kazakh National University, Almaty, Kazakhstan
Institute of Higher Medical Postgraduate Education, Akhmet Yassawi University, Turkestan, Kazakhstan
Department of Public Health and Management, Astana Medical University, Nur-Sultan, Kazakhstan
Department of Family Medicine #2, Astana Medical University, Nur-Sultan, Kazakhstan
Institute of Pharmacy, Sechenov First Moscow State Medical University, Moscow, Russian Federation
Laboratory of Food Chemistry, Federal Research Center of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation
Independent Researcher, Almaty, Kazakhstan
Department of Rheumatology and Noncommunicable Diseases, Semey Medical University, Semey, Kazakhstan
School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan

Department of Public Health
Faculty of Medicine and Healthcare
Institute of Higher Medical Postgraduate Education
Department of Public Health and Management
Department of Family Medicine #2
Institute of Pharmacy
Laboratory of Food Chemistry
Independent Researcher
Department of Rheumatology and Noncommunicable Diseases
School of Medicine

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