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.
#Bone stimulator cost full#
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.
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