hta_ knee intro.qxp - Ministero della Salute

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54 Figure 8.1 shows prostheses ICERs as dots scattered around the axis. The upper right hand quadrant includes models which are less effective than the base line model but have lower cost. The upper left had quadrant includes prostheses which have higher costs and lower effectiveness than baseline. NEXGEN LPS is the most cost-effective prosthesis as it is very near the zero value, meaning that the difference in effectiveness is very small. Only NEXGEN LPS has similar cost-effectiveness. Figure 8.1: Cost-effectiveness representation SCORPIO has the highest effectiveness of single-radius design prostheses according to RIPO revision rates. SCORPIO is the dominant technology as it has the lowest cost and the lowest revision rate (Table 8.2). The negative ICER indicates the lower cost-effectiveness of PROFIX compared to SCORPIO which is not surprising given the premium price of the PROFIX femoral Oxinium component.
Table 8.2: ICER (RIPO data) for single-radius class – Prosthesis base line: SCORPIO MODEL NAME (Manufacturer) PROFIX (Smith & Nephew) Source: Agenas elaboration MEAN WEIGHTED PRICE 2007 REVISION RATE at 5 years (%) 8.3.2 Results using AOAJRR data IMPLANT SURVIVAL RATE at 5 years (%) C E ICER € 4.609,28 2,4 97,6 - € 2.100,55 0,7 - € 3.000,79 SCORPIO (Stryker) € 2.508,73 1,7 98,3 Base line According to AOAJRR data, in the class of multiradius femoral design, the prosthesis with highest effectiveness is P.F.C. SIGMA. We defined this as our base line prosthesis. P.F.C. SIGMA is also the dominant prosthesis compared to LCS, GENESIS II OXINIUM and NEXGEN LPS-FLEX as shown by their negative ICERs. The other prosthesis types (AGC, BALANSYS, GENESIS II and NEX- GEN LPS) have a positive incremental cost as they are cheaper than base line (Table 8.3). The effectiveness differentials are all positive because by definition the baseline prosthesis is the most effective. Figure 8.2 shows graphically variations of costs and effects by model compared with the base line model. NEXGEN LPS has the highest cost-effectiveness as it has similar effectiveness (the difference against base line is 0,1%) but costs € 458,62 less than base line. 55
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HTA REPORT Prostheses for primary t
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Contributions Authors Marina Cerbo,
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HTA REPORT Prostheses for primary t
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10. Recommendations . . . . . . . .
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Prefazione Quest’anno l’Agenas
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XII Results Literature in this fiel
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XIV Obiettivi del report L’interv
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XVI formati e delle variabili racco
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2 The procedures were identified ac
Page 21 and 22: 2. Technology, procedure and altern
Page 23: 3. The marketing status of knee pro
Page 27 and 28: 5. Context-specific analysis Contex
Page 29 and 30: Figure 5.1: Type of centres in the
Page 31 and 32: Figure 5.2: Percentage of respondin
Page 33 and 34: Table 5.3: Volume of purchased pros
Page 35 and 36: 5.2.5 Analysis on purchasing price
Page 37: Table 5.6: Distribution of mean wei
Page 40 and 41: 24 6.1.3 Evidence synthesis After t
Page 42 and 43: 26 Survival rate as “revision for
Page 44: 28 Table 6.1: Evidence table for si
Page 49 and 50: 7. Assessing the evidence from arth
Page 51 and 52: Only four reports out of the 9 repo
Page 53 and 54: Table 7.3: Variables used in each r
Page 55 and 56: Table 7.4: Replies from the key-per
Page 57 and 58: Table 7.6: Data from the Australian
Page 59 and 60: Table 7.8: Data from Registro dell
Page 61 and 62: Table 7.11: Data from the Australia
Page 63 and 64: Table 7.15: Data from Registro dell
Page 65: Table 7.18: Revision rates of uncem
Page 68 and 69: 52 We calculated ICERs only for cla
Page 72 and 73: 56 Table 8.3: ICER (AOAJRR data) fo
Page 74 and 75: 58 8.4 Conclusions Regardless of wh
Page 76 and 77: 60 The gross heterogeneity of repor
Page 79: 10. Recommendations We recommend th
Page 83: 12. Competing interests declaration
Page 86 and 87: 70 22. http://www.agenas.it/monitor
Page 88 and 89: 72 • a tibial component: a metall
Page 90 and 91: 74 Retention or sacrifice of the po
Page 92 and 93: 76 Figure A1.2: Examples of femoral
Page 94 and 95: 78 Suggested readings Bronzino JD.
Page 97 and 98: Appendix 2 Survey of Medical device
Page 103 and 104: Appendix 3 Sampling methodology The
Page 105: Table A2.2: Sample and total centre
Page 108 and 109: 92 Veneto: 050017 Ospedale Sacro Cu
Page 110 and 111: 94 Basilicata: 170011 Presidio Ospe
Page 113 and 114: Appendix 6 Search strategy The sear
Page 115 and 116: #50. (hls AND noetos) AND tornier A
Page 117 and 118: #108. (prime) AND (exatech) AND pri
Page 119 and 120: #166. (vanguard AND ps) AND ('biome
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Select 6 document(s) Search ("1998-
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Search ("1998-01-01"[Publication Da
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Appendix 7 Data extraction form for
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Common characteristics: Manufacture
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Conclusions: Assessment of generali
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Appendix 8 Data extraction form for
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Appendix 9 Quality assessment tool
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Appendix 10 List of excluded studie
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Studies excluded for short follow-u
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Robinson RP. Five-year follow-up of
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Regnér L, Carlsson L, Kärrholm J,
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Appendix 11 List of included studie
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Acronyms and abbreviations Agenas A
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